title: Recovery of Urinary Functions After Laparoscopic Total Mesorectal Excision for T4 Rectal Cancer.
abstract: BACKGROUND
  Postoperative urinary dysfunction after total mesorectal excision (TME) is lessened by preservation of the autonomic nerves, but in T4 rectal tumors such injury often cannot be prevented. This retrospective study evaluated the recovery of urinary function of patients with injury to a single pelvic autonomic nerve subsequent to laparoscopic TME, relative to patients without nerve damage.
  
  
  METHODS
  Patients with T4 rectal cancer who underwent laparoscopic TME were divided according to the presence of a single pelvic autonomic nerve injury (37 cases) or no injury to autonomic nerves (54 cases; control). Urinary function was evaluated before surgery and at 1 and 6 months after surgery based on catheter indwelling time, urodynamics, International Prostate Symptom Score (IPSS; men only), and Urogenital Distress Inventory (UDI-6) score (women).
  
  
  RESULTS
  One month after surgery in the injured and control groups, the postoperative catheter indwelling time was 6.2 ± 2.0 and 1.9 ± 1.2 days, respectively; the maximal urinary flow rates were 16.6 ± 5.8 and 19.7 ± 5.5 mL/s; the voided volumes were 181.6 ± 65.9 and 211.7 ± 63.2 mL; and the residual volumes were 15.0 ± 8.5 and 10.8 ± 8.0 mL. However, at the 6-month follow-up, all urodynamic parameters of the two groups were statistically similar and indicated recovery, and the IPSS and UDI-6 scores were also not statistically different.
  
  
  CONCLUSIONS
  Damage to a single pelvic autonomic nerve during laparoscopic TME does not lead to long-term urinary dysfunction.
authors.affiliation: 1 Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University , Xi'an, P.R. China .
authors.forename: Qiao
authors.initials: Q
authors.lastname: Qiao
authors.affiliation: 2 Department of General Surgery, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University , Xi'an, P.R. China .
authors.forename: Xiangming
authors.initials: X
authors.lastname: Che
authors.affiliation: 2 Department of General Surgery, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University , Xi'an, P.R. China .
authors.forename: Xuqi
authors.initials: X
authors.lastname: Li
authors.affiliation: 2 Department of General Surgery, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University , Xi'an, P.R. China .
authors.forename: Shicai
authors.initials: S
authors.lastname: He
authors.affiliation: 2 Department of General Surgery, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University , Xi'an, P.R. China .
authors.forename: Guanglin
authors.initials: G
authors.lastname: Qiu
authors.affiliation: 2 Department of General Surgery, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University , Xi'an, P.R. China .
authors.forename: Jing
authors.initials: J
authors.lastname: Lu
authors.affiliation: 2 Department of General Surgery, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University , Xi'an, P.R. China .
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: 2 Department of General Surgery, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University , Xi'an, P.R. China .
authors.forename: Lin
authors.initials: L
authors.lastname: Fan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017776:Autonomic Pathways / Q000293:injuries*; D002408:Catheters, Indwelling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology*; D020127:Recovery of Function; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D014563:Urodynamics