Urodynamic evaluation in patients after radical resection of the rectum
Article published in Urologia Polska 2001/54/1.

authors

Zygmunt Dobrowolski ¹, Wiesław Węglarz ¹, Wacław Lipczyński ¹, Piotr Richter ², Andrzej Strach ¹

¹ Katedra i Klinika Urologii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie
Kierownik Kliniki: drhab. med. Zygmunt Dobrowolski
² I Katedra i Klinika Chirurgii Ogólnej i Gastroenterologicznej
Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie
Kierownik Kliniki: prof, drhab. med. Tadeusz Popiela

keywords

rectum, rectal carcinoma, miction disorders, urodynamic examinations

summary

Introduction. In patients after radical resection of the rectum, as a results of bilateral injury (o the hypogastric plexus and less frequently to the pelvis nerve, the bladder becomes disconnected from the central nervous system. The detrusor loses partly or totally its ability of reflexive contractions. It leads to urine retention in the bladder. The frequency of this injury concers 10-60% of the operated patients.

Material and method. In 30 patients after radical resection of the rectum the complex urodynamic examinations (cystometry with electromyography, uroflowmetry, urethral profilomctry, mictiometry) were made three and six months after the operation.

Results. Miction disturbances due to hypo- or areflection, leading to partial or total retention of urine in the bladder were found in 12 patients. In these patients phannacological treatment was applied, administrating causing relaxation of bladder neck and proximal urethral sphincter (selective blockers ala-tamsulozine) and drugs stimulating the contractile function of the detrusor (blocker of acetylocholinesterasis - distigmine bromide, ubretid). The control urodynamic examinations made after 6 months from the start of the treatment have shown radical improvement in empting bladder in 4 cases

references

correspondence