Major urinary dysfunction after mesorectal excision for rectal carcinoma.
BACKGROUND
Urinary dysfunction may occur after mesorectal excision and pelvic autonomic nerve preservation (PANP) in patients with rectal carcinoma. The aim of this prospective study was to identify factors predictive of long-term urinary catheterization.


METHODS
Two hundred and ten patients without significant urological problems underwent resection of rectal cancer with mesorectal excision. The number of patients with complete, partial or no identification of the nerves was documented and correlated with possible predictive factors for postoperative major urinary dysfunction.


RESULTS
Eight patients (3.8 per cent) required long-term urinary catheterization: two after complete PANP (two of 168) and six in whom PANP was incomplete (six of 42) (P = 0.001). Multiple regression analysis identified incomplete PANP (odds ratio 13.8 (95 per cent confidence interval 2.7 to 71.3); P = 0.002) as a predictive factor for major urinary dysfunction.


CONCLUSIONS
Major urinary dysfunction after mesorectal excision for rectal cancer is associated with an incomplete nerve-sparing technique.
Kneist
W
W
Department of General and Visceral Surgery, Johannes Gutenberg University Hospital, Langenbeckstrasse 1, 55131 Mainz, Germany. kneist@ach.klinik.uni-mainz.de
Heintz
A
A
Junginger
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001342:Autonomic Nervous System Diseases / Q000209:etiology; D017776:Autonomic Pathways / Q000293:injuries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D012044:Regression Analysis; D012307:Risk Factors; D014546:Urinary Catheterization; D014555:Urination Disorders / Q000209:etiology*