A study of Minimum Requirement of Pelvic Splanchnic Nerve Preservation for Urinary Function after Radical Operation for Rectal Cancer

Takeshi Sakashita

The Second Department of Surgery, Yokohama City University School of Medicine Yokohama, Japan.

The purpose of this study was to investigate the minimum requirement of pelvic splanchnic nerve preservation for urinary function after a radical operation for rectal cancer, and a urodynamic study was conducted to determine whether restoration of urinary function can be predicted. Fifty-nine patients after rectal resection were divided into a non-preserving group (n=19) and a partial-preserving group (n=40). The minimum requirement for pelvic splanchnic nerve preservation was determined by scoring the preserved nerves (preserving score). The urodynamic study was performed in 16 patients in the partial-preserving group 1 month after the operation. Urinary function both of 3 months after and 6 months after the operation was better in the partial preserving group than the non-preserving group. Urinary function 3 months after operation was significantly better in the group with more than 2 points in preserving score than the group with 1 point (p=0.014). Those patients whose first desire to void (FDV) yieleded less than 200ml or whose maximal desire to void (MDV) yielded less than 400ml had the possibility of release from self-catheterization until3 months after the operation. These results suggest that the minimum requirement for urinary function in 2 points in preserving score that means bilateral S4 or unilateral S3S4 preserving and the restoration of urinary function can be predicted by FDV and MDV one month after the operation.

Key words
minimum requirement of pelvic splanchnic nerve preservation for urinary function, preserving score of pelvic splanchnic nerve, urodynamic study for prediction of post-operative urinary function, radical operation for rectal cancer

Reprint requests
Takeshi Sakashita The Second Department of Surgery, Yokohama City University School of Medicine 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0005 JAPAN

Accepted
November 13, 1998

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