A Calpista

DC Winter

F Pata

O Asoglu

R Romano

R Sacco

T Mitsui

V Orsini

English

PubMed

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MEETING ABSTRACT Open Access
Urinary dysfunctions in local advanced rectal
carcinoma: urodynamic features and impact of
associated-age diseases
R Sacco*, V Orsini, R Romano, F Pata
From de Senectute: Age and Health Forum
Catanzaro, Italy. 5-7 December 2009
Background
Voiding dysfunctions are common complications after
rectal cancer resection, secondary to injury to the auto-
nomic nervous plexus. In locally advanced rectal cancer
nervous damage can be necessary in order to obtain
curative resection. However, the development of a new
surgical technique such as Total Mesorectal Excision,
nerve sparing dissection (and about multivisceral resec-
tions bladder- sparing operations) and greater under-
standing of the regional anatomy has improved survival
and decreased voiding and sexual dysfunction rates [1].
Material and methods
Between January and December 2003, 35 patients under-
went surgery for colorectal cancer (10 left hemicolectomies
21 anterior resections and 4 abdomino-perineal resections).
All patients underwent multichannel urodynamic evalua-
tion. The data collected were: bladder capacity and compli-
ance, sensitivity and contractility, and obstruction outlet.
Results
Twelve months after surgery, urodynamic alterations
were found in 14 patients (40%); the most frequent pat-
terns were detrusor overactivity (4 pts), vesico-sphincter
dyssynergia (5 pts) and neurogenic bladder (2 pts).
However, in six patients (5 of left hemicolectomy
group and 1 of Miles’ group) obstruction outlet due to
benign prostatic hypertrophy was discovered.
Conclusions
The optimal way to objectively describe urinary dysfunc-
tions is by careful urologic history and urodynamic
investigation before and after the operation.
In males over the age of 65, minimal neural damage
during surgery may complicate any pre-existing blad-
der outlet obstruction from benign prostatic hyper-
trophy [2].
Laparoscopic rectal resection doesn’t adversely affect
bladder function, but isn’t indicated for local rectal
cancer [3]. Bladder dysfunction after colorectal surgery
can be avoided by identifying and preserving the pelvic
autonomic nerves, according to oncologic radicality in
performing total mesorectal excision and, if possible,
preferring bladder-sparing surgery respect to pelvect-
omy [4].
Published: 19 May 2010
References
1. Calpista A, Lai S, Agostini A, Mancini M, Artibani W: Functional urological
complications after colo-rectal cancer surgery. Pelviperineology 2007,
26:38-401.
2. Mitsui T, Shinno Y, Kobayashi S, Matsuura S, Shibata T, Ameda K,
Koyanagi T: Persistent vesicourethral dysfunction following radical
surgery for rectal carcinoma: urodynamic features and potential
abatement with modified sphincterotomy (radical transurethral
resection of the prostate). Int J Urol 1998, 5(1):39-43.
3. Asoglu O, Matlim T, Karanlik H, et al: Impact of laparoscopic surgery on
bladder and sexual function after total mesorectal excision for rectal
cancer. Surg Endosc 2009, 23(2):296-303.
4. Winter DC, Walsh R, Lee G, Kiely D, O’Riordain MG, O’Sullivan GC: Local
involvement of the urinary bladder in primary colorectal cancer:
outcome with en-bloc resection. Ann Surg Oncol. 2007, 14(1):69-73.
doi:10.1186/1471-2318-10-S1-A32
Cite this article as: Sacco et al.: Urinary dysfunctions in local advanced
rectal carcinoma: urodynamic features and impact of associated-age
diseases. BMC Geriatrics 2010 10(Suppl 1):A32.
General Surgery, “Magna Graecia” University, Catanzaro, Italy
Sacco et al. BMC Geriatrics 2010, 10(Suppl 1):A32
http://www.biomedcentral.com/1471-2318/10/S1/A32
© 2010 Sacco et al; licensee BioMed Central Ltd.


Urinary dysfunctions in local advanced rectal carcinoma: urodynamic features and impact of associated-age diseases

Crossref

Pata F

Romano R

Orsini V

Sacco R

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BMC Geriatrics

Artibani W: Functional urological complications after colo-rectal cancer surgery. Pelviperineology

et al: Impact of laparoscopic surgery on bladder and sexual function after total mesorectal excision for rectal cancer. Surg Endosc

GC: Local involvement of the urinary bladder in primary colorectal cancer: outcome with en-bloc resection. Ann Surg Oncol.

T: Persistent vesicourethral dysfunction following radical surgery for rectal carcinoma: urodynamic features and potential abatement with modified sphincterotomy (radical transurethral resection of the prostate).

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Urinary dysfunctions in local advanced rectal carcinoma: urodynamic features and impact of associated-age diseases

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