Care and treatment of spinal cord injury patients.
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Biomedical subjects
Publications and source records attributed to J E Binard.
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We describe the results of prostatic balloon dilation in 7 patients with a follow-up of 9 months. Symptom scores dramatically fell in 5 patients (success rate 71%), which is confirmed by a significant improvement in peak flow in 4 of them. Two patients failed to improve and needed a subsequent intervention which revealed a stage A2 prostatic carcinoma in one. During subsequent open prostatectomy, a condition analogous to dilation with the Deisting dilator was seen. We conclude that the indications and results obtained with the balloon dilator are similar to those with the Deisting dilator.
A new and simple endoscopic treatment procedure of external urethral sphincters is described. The external urethral sphincter was dilated with a balloon catheter 25mm in diameter in a multiple sclerosis patient; the sphincter spasticity made intermittent catheterization impossible. Post dilatation, the resistance to catheterization completely disappeared and the urethral pressure profile showed a dramatic fall in sphincteric pressure. This fall in sphincteric pressure has remained at a normal post dilatation level at the time of submission of this article (7 months).
Electrical stimulation of the external urethral sphincter is a valuable aid in teaching sphincterotomies and transurethral procedures. It helps accurately locate the external urethral sphincter which should be transected totally during a sphincterotomy and left intact in a transurethral procedure.
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