[Urologic complications in rectal surgery (author's transl)]

Urinary disorders after amputation or resection of the rectum are much more frequent than commonly supposed. Out of 239 patients they were noticed by 56.6%, undergoing amputation, and 36.6% after resection. Longterm disturbances were observed by 26.4% respect. 15.1%. The most important reason is injury of autonomic pelvic nerves and ganglia. Urinary bladder infection was verified in 22% respect. 8%. Furthermore urinary disorders may be caused by changing of bladder localization (bladder hernia), wound infection (especially of the sacral cavity), edema of the urethra, and exacerbation or manifestation of pre-existing urologic diseases. Compared to these, lesions of the urinary tract are of little importance. To prevent such complications, we postulate: 1. careful pre-operative urologic examination, 2. if possible mobilisation of the rectum along its borderlines (so-called Grenzlamellen of Pernkopf), 3. critical analysis of urologic disorders, removal of the urinary catheter as soon as possible, regular systemic prophylaxis of urinary infection, and therapy controlled by antibiogram, 4. adequate follow-up, and 5. urologic examination of all disturbances lasting longer than three months.