Clinical and Experimental Study of the Effect of Unilateral Autonomic Nerve-preserving Operation for Rectal Cancer on Contractile Function of the Internal Urethral Orifice

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

First Department of Surgery, Kagoshima University School of Medicine

Twenty male patients who underwent curative resection for rectal cancer were divided into 3 groups according to technical differences in preserving the autonomic nerves, i.e., bilateral-preserving, unilateral-preserving and bilateral resecting. The maximal urethral closure pressure (MUCP) was measured by the findings of the urethral closure pressure profile. MUCP decreased markedly in the bilateral-resecting group post-operatively. In the unilateral-preserving group, MUCP showed a significant decrease one month after the operation, but it recovered gradually thereafter, to 70 to 80% of normal levels. We applied the 3 operative procedures to dogs and measured MUCP in the same manner under electrical stimulation of a hypogastric nerve. In the bilateral-preserving group, MUCP showed values near the normal range through out the experimental period. MUCP in the unilateralpreserving group were decreased significantly one week after the operation, but recovered thereafter and maintained levels a little lower than those of the bilateral-preserving group. MUCP decreased significantly and did not recover in the bilateral-resecting group postoperatively. The results indicate that retrograde ejaculation may well be prevented by the unilateral autonomic nerve-preserving operation.

Key words
rectal cancer, internal urethral orifice, unilateral autonomic nerve preserving operation, urethral closure pressure profile, retrograde ejaculation

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

Accepted
October 9, 1991

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