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Anorectal and urinary dysfunction after surgery for rectal cancer.
Roman M Herman1, Piotr J Thor, Jacek Sobocki
1III Katedra Chirurgii, Collegium Medicum Uniwersytetu Jagiellońskiego.
Folia Medica Cracoviensia
|November 3, 2005
Summary
Rectal surgery can cause anorectal and urinary dysfunction due to pelvic nerve damage. Low anterior resection showed a higher correlation between these dysfunctions compared to local excision.
Area of Science:
- Colorectal Surgery
- Urology
- Pelvic Floor Dysfunction
Background:
- The relationship between anorectal and urinary dysfunction post-rectal surgery remains unclear.
- Pelvic autonomic plexus damage is a suspected cause of these dysfunctions.
Purpose of the Study:
- To investigate the correlation between anorectal and urinary dysfunction after different types of rectal surgery.
- To explore the underlying pathomechanisms of these post-surgical complications.
Main Methods:
- Forty-four patients were divided into three groups based on surgical procedure: abdomino-perineal resection, low anterior resection, and local excision.
- Urodynamic evaluation (uroflowmetry, residual urine volume, cystometry) and anorectal manometry were performed 5-9 months post-surgery.
- Patients completed questionnaires on voiding and fecal continence symptoms.
Main Results:
- Low anterior resection (Group B) showed a significant correlation between anorectal and urinary symptoms (p=0.055).
- Urinary disturbances were most common in Group B (90%).
- Manometrically confirmed dysfunction was significantly higher after low anterior resection compared to local excision (p<0.05).
Conclusions:
- A significant correlation exists between anorectal and urinary dysfunction following rectal surgery.
- Partially similar pathomechanisms, likely involving pelvic autonomic plexus damage during oncological rectal dissection, contribute to these dysfunctions.