Evaluation of clinical indexes to predict fate of pelvic nerve dysfunction

This study was designed to evaluate posterior urethral sensation and sacral reflex evoked by posterior urethral stimulation to predict fate of pelvic nerve dysfunction. Enrolled were 24 male patients sequentially receiving the following examinations 1-3 months (postoperative) and more then 6 months (follow-up) after surgery for rectal cancer: sensory thresholds of the penile skin (SS) and the posterior urethra (SU), sacral reflex evoked by penile stimulation (BCR) and posterior urethral stimulation (UUR), and urodynamic study. Controls included 25 patients with normal voiding function before pelvic surgery. SS, SU and latencies of BCR and UUR averaged 1.9+/-0.6 mA, 5.6+/-1.8 mA, 33.3+/-4.2 ms and 65.0+/-9.3 ms in controls, respectively, and unchanged postoperatively in 13 patients with normal voiding function. Of 11 patients with voiding dysfunction whose SS and latency of BCR remained unchanged, SU increased in 7, voiding function remained unrecovered in 6 patients during the follow-up period and recovered in the remaining 5. None of four patients with nonevocable UUR recovered voiding function. Thus, unchanged SU and disappearance of UUR were useful to predict recovery and nonrecovery of postoperative voiding dysfunction, respectively.