Urinary Function Following Resection for Rectal Cancer with Preoperative Radiation Therapy

Yoshinori Shirai, Masao Nunomura*, Hiromi Sarashina*, Norio Saitoh*, Shinji Taniyama, Tatsuo Arai, Masato Ono, Nobuyuki Nakajima*

Department of Gastroenterol Surgery, National Cancer Center Hospital, East
*First Department of Surgery, School of Medicine, Chiba University

Urinary function was evaluated after personal interview in 34 patients and after examination of the results of a urodynamic study in 15 of these, in whom resection for carcinoma of the rectum with preoperative irradiation therapy was performed. From the results of the personal interview, urinary urgency was found to have occurred in 19.2% when preoperative radiation was over. Urinary function after surgery was preserved in the group of patients who had undergone bilateral and unilateral pelvic plexus nerve preserving operations, whereas urinary dysfunction occurred in 66.7% of the group of patients who had undergone operations without pelvic plexus nerve preservation. Urinary dysfunction was recognized in 53.9% of the group of patients who had undergone abdominoperineal resection, but in none of the group of patients who had undergone low anterior resection. The urodynamic study showed that 21.4% had residual urinary output of more than 40 ml, 23.1% had the first desire to void at less than 100 ml, 15.4% had the maximum desire to void at less than 200 ml, 28.6% had compliance of the bladder at less than 20 ml/cmH₂O when preoperative irradiation was over, and these data became worse I month after surgery. However these phenomena were improved 1 year after surgery.

Key words
rectal cancer, preoperative irradiation therapy, urinary function

Reprint requests
Yoshinori Shirai Department of Gastroenterol Surgery, National Cancer Center Hospital, East
6-5-1 Kashiwanoha, Kashiwa, 277 JAPAN

Accepted
September 8, 1993

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