A sound anatomical and physiological basis has now been provided for the endoscopic operations which are carried out for the relief of urethral obstruction due to spasticity of the external sphincter. However, the operation ‘external sphincterotomy’ was originally applied empirically to cases with sacral areflexia in which the mechanism of the obstruction was obscure. It now seems that plain muscle contraction under sympathetic control and influenced by posture is probably responsible and there are prospects of relief from the use of alpha-adrenergic blocking agents. When endoscopic incision is required, the operation might be better designated ‘internal membranous urethrotomy’.
Abel, B J, Gibbon, N O K, Jameson, R M & Krishnan, K R (1974). The neuropathic urethra. Lancet, 2, 1229–1230.
Abel, B J, Gibbon, N O K, Jameson, R M & Ross, J C (1975). Urethral profile measurement after division of the external sphincter. Paraplegia, 13, 37–41.
Currie, R J, Bilbisi, A A, Schiebler, J C & Bunts, R C (1970). External sphincterotomy in paraplegics: technique and results. Journal of Urology, 103, 64–68.
Diokno, A C, Koff, S A & Bender, L F (1974). Periurethral striated muscle activity in neurogenic bladder dysfunction. Journal of Urology, 122, 743–749.
Dollfus, P, Jurascheck, F, Jacob-Chiad & Peter, R (1972). Prostato-cystopexy for a paraplegic case with an inactive bladder and perineum. Paraplegia, 10, 64–67.
Donker, P J, Ivanovici, F & Noach, E L (1972). Analyses of the urethral pressure profile by means of electromyography and the administration of drugs. British Journal of Urology, 44, 180–193.
Elbadawi, A & Schenk, E A (1974). A new theory of the innervation of bladder musculature. Part 4. Innervation of the vesico-urethral function and external urethral sphincter. Journal of Urology, 111, 613–615.
Enhorning, G (1961). Simultaneous recording of intravesical and intraurethral pressure. Acta Chir. Scand., Suppl. 276.
Gibbon, N O K (1966). Management of the bladder in acute and chronic disorders of the nervous system. Acta Neurol. Scandinavica, 42, 133–153.
Gibbon, N O K (1973). Division of the external sphincter. British Journal of Urology, 45, 110–115.
Gil Vernet, S (1965). Innervation of the urinary bladder and posterior urethra. Arch. d'Anat. Path. 12, 119–125.
Haines, R W (1966). The striped compressor of the prostatic urethra. British Journal of Urology, 41, 481–493.
Johnston, J H & Kathel (1971). The obstructed neurogenic bladder in the newborn. British Journal of Urology, 43, 206.
Koontz, W W, Vernon-Smith, M J & Currie, R J (1972). External sphincterotomy in boys with meningomyelocoele. Journal of Urology, 108, 649–651.
Linker, D G & Tanagho, E A (1975). Complete external sphincterotomy: correlation between endoscopic observation and the anatomic sphincter. Journal of Urology, 113, 348–352.
Sant, G R (1972). The anatomy of the external striated urethral sphincter. Paraplegia 10, 153–156.
Vincent, S A (1966). Some aspects of bladder mechanics. Biomedical Engineering, Sept., 1–8.
About this article
Cite this article
Gibbon, N. A further look at the rationale of ‘external sphincterotomy’. Spinal Cord 13, 243–246 (1976). https://doi.org/10.1038/sc.1975.38