Anorectal and bladder function after sacrifice of the sacral nerves

Area of Science:

• Urology
• Colorectal Surgery
• Neuroscience

Background:

• Sacral nerve function in bladder and anorectal control is critical.
• Limited research exists on the functional impact of sacral nerve sacrifice due to sacral tumors.
• Understanding these changes is vital for patient management and surgical planning.

Purpose of the Study:

• To quantitatively assess bladder and anorectal function before and after sacral nerve division.
• To evaluate the impact of sacral nerve sacrifice in patients undergoing surgery for sacral bone tumors.

Main Methods:

• Prospective study involving five patients with sacral tumors.
• Sacral nerve division was performed either unilaterally or bilaterally.
• Anorectal and bladder functions were assessed using manometry, cystometry, and symptom evaluation.

Main Results:

• Unilateral sacral nerve sacrifice resulted in minimal functional deficits, though increased residual urine volume was noted.
• Bilateral sacral nerve sacrifice led to significant issues with defecation urge, sensory discrimination of feces/flatus, and urgency.
• Fecal incontinence was infrequent due to stool consistency; enemas were effective for management in most bilateral cases.

Conclusions:

• Unilateral sacrifice of sacral nerves appears to have a limited impact on bladder and anorectal function.
• Bilateral sacrifice of sacral nerves can cause substantial and potentially debilitating anorectal dysfunction.
• Further research is needed to fully elucidate the long-term functional consequences and management strategies.