Outcomes and complications of sphincterotomy with bladder neck incision in neurologically healthy male patients with voiding dysfunction.

OBJECTIVES To evaluate the efficacy, complications and outcomes of sphincterotomy with bladder neck incision in patients with voiding dysfunction (VD). METHODS We evaluated our prospectively established urologic urodynamic database and identified the records of 30 male patients with VD that underwent sphincterotomy between Octuber 1993 and December 2008. The IPSS and urodynamics were analyzed before and after surgery, we recorded the outcomes and complications. Numerical data were analyzed with Student`s t and Wilcoxon tests (p < 0.05). ANOVA was used for the follow up. RESULTS Thirty patients underwent sphincterotomy with a mean age of 41 years (range 18-63 years). Statistical differences (p< 0.05) were found for: maximum flow rate (17.61 ± 7.7 vs 23.5 ± 12.19 ml/s), detrusor pressure (73.53 ± 21.51 vs 47.4 ± 16.24 cmH20), maximum cystometric capacity (462.74 ± 224.2 vs 382.2 ± 167.48 ml), functional urethral length (64.3 ± 22.6 vs 42.2 ± 18.4 mm), Maximum urethral pressure (120.1 ± 46.8 vs 59.23± 22.67 cmH20), total urethral closure area (3315 ± 1269.7 vs 1189 ± 49.23 cmH20*mm) and postvoid residual volume (161.3 ± 177.9 vs 57 ± 100.8 ml). The IPSS improved and was stable at 60 months (p < 0.02). No significant association was found to develop incontinence after the procedure. CONCLUSION Sphincterotomy for male patients with dysfunctional voiding improves voiding dynamics with a low rate of complications and minimum risk of incontinency.