title: Bladder and rectal incontinence without paraplegia or paraparesis after endovascular aneurysm repair.
abstract: Spinal cord ischemia is a well-known potential complication of endovascular aneurysm repair (EVAR), and it is usually manifested by paraplegia or paraparesis. We describe a case in which spinal cord ischemia after EVAR presented by isolated bladder and rectal incontinence without other neurological deficits. A 63-year-old woman presented with intermittent claudication secondary to an infrarenal abdominal aortic aneurysm (AAA), and a left common iliac artery obstruction, for which she underwent EVAR using an aorto-uniiliac (AUI) device and ilio-femoral artery bypass. On postoperative day 3, she developed urinary and fecal incontinence without signs of paraplegia or paraparesis. Magnetic resonance imaging (MRI) showed a hyper-intense signal in the spinal cord. She received hyperbaric oxygen (HBO) therapy and was discharged after 18 days when her urinary and fecal incontinence were almost resolved. This report suggests that spinal cord ischemia after EVAR for aortoiliac occlusive disease might present as bladder and rectal incontinence without other neurological manifestations.
authors.affiliation: Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. naritomo.n@nifty.com.
authors.forename: Naritomo
authors.initials: N
authors.lastname: Nishioka
authors.affiliation: Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. kurimoto-spr@umin.ac.jp.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kurimoto
authors.affiliation: Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. ryushim@hotmail.com.
authors.forename: Ryushi
authors.initials: R
authors.lastname: Maruyama
authors.affiliation: Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. white_shepherds_khno@hotmail.com.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Ujihira
authors.affiliation: Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. iba-yu@keijinkai.or.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Iba
authors.affiliation: Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. hatta_ei@hotmail.com.
authors.forename: Eiichiro
authors.initials: E
authors.lastname: Hatta
authors.affiliation: Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. ayamada@keijinkai.or.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamada
authors.affiliation: Department of Cardiovascular Surgery, Teine Keijinkai Hospital, 12-1-40, Maeda 1-jo, Teine-ku, Sapporo, Hokkaido, 006-8555, Japan. k-naka.tdr@keijinkai.or.jp.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Nakanishi
keywords: Abdominal aortic aneurysm (AAA); Aorto-uniiliac (AUI) device; Bladder and rectal complications; Bladder and rectal incontinence; Endovascular aneurysm repair (EVAR); Hyperbaric oxygen (HBO) therapy