6533b820fe1ef96bd1279097

RESEARCH PRODUCT

Major urinary dysfunction after mesorectal excision for rectal carcinoma

Achim HeintzWerner KneistTheodor Junginger

subject

AdultMalemedicine.medical_specialtyColorectal cancerUrinary systemmedicine.medical_treatmentUrinary catheterizationPostoperative ComplicationsRisk FactorsmedicineHumansAutonomic PathwaysProspective StudiesProspective cohort studyAgedMesorectalAged 80 and overRectal Neoplasmsbusiness.industryUrination disorderOdds ratioMiddle AgedUrination Disordersmedicine.diseaseConfidence intervalSurgeryAutonomic Nervous System DiseasesRegression AnalysisFemaleSurgeryUrinary Catheterizationbusiness

description

Abstract Background Urinary dysfunction may occur after mesorectal excision and pelvic autonomic nerve preservation (PANP) in patients with rectal carcinoma. The aim of this prospective study was to identify factors predictive of long-term urinary catheterization. Methods Two hundred and ten patients without significant urological problems underwent resection of rectal cancer with mesorectal excision. The number of patients with complete, partial or no identification of the nerves was documented and correlated with possible predictive factors for postoperative major urinary dysfunction. Results Eight patients (3·8 per cent) required long-term urinary catheterization: two after complete PANP (two of 168) and six in whom PANP was incomplete (six of 42) (P = 0·001). Multiple regression analysis identified incomplete PANP (odds ratio 13·8 (95 per cent confidence interval 2·7 to 71·3); P = 0·002) as a predictive factor for major urinary dysfunction. Conclusion Major urinary dysfunction after mesorectal excision for rectal cancer is associated with an incomplete nerve-sparing technique.

https://doi.org/10.1002/bjs.4867