Usefulness of Unilateral Autonomic Nerve-preserving Operation for Prevention of Urinary and Sexual Dysfunctions after Rectal Cancer Surgery

Kazutaka Yamada, Takashi Sameshima, Jun-ichiro Sameshima, Katsuro Haruyama, Shigeya Hase, Yoshinori Katsura, Kiyoshi Niwa, Takashi Ishizawa, Hisaaki Shimazu

First Department of Surgery, Kagoshima University School of Medicine

Postoperative dysfunctions after a unilateral autonomic nerve-preserving operation (A-I; 10 cases) for rectal cancer were compared with those after a bilateral autonomic nerve-preserving operation (A-II; 21 cases), conventional rectal resection (B-I; 25 cases) and extended rectal resection with iliopelvic lymphadenectomy (B-II; 44 cases) from the results of a questionnaire survey. No urinary dysfunction occurred in patients who underwent A-I and A-II operations, whereas dysuria and a sense of residual urine occurred at incidences of 4% and 8% after the B-I operations, and 30% and 25% after the B-II operations. Incidences of ejaculation and erection dysfunctions after each surgical method were respectively, 20% and 0% after the A-I operations, 50% and 17% after the A-II operations, 57% and 36% after the B-I operations, and 75% and 63% after the B-II operations. However, the ejaculation dysfunctions in patients who underwent A-I or A-II operations were all the retrograde ejaculation type. Moreover, the differences in incidence of these dysfunctions were more marked in patients receiving abdominoperineal resection, a pull-through operation or a Welch operation.

Key words
unilateral autonomic nerve preserving operation, urinary dysfunction after rectal cancer surgery, sexual dysfunction after rectal cancer surgery

Reprint requests
Kazutaka Yamada First Department of Surgery, Kagoshima University School of Medicine
8-35-1 Sakuragaoka, Kagoshima, 890 JAPAN

Accepted
April 17, 1991

To read the PDF file you will need Abobe Reader installed on your computer.