Long-term urinary dysfunction after mesorectal excision: A prospective study with intraoperative electrophysiological confirmation of nerve preservation

Kneist, W.; Junginger, T

doi:10.1016/j.ejso.2007.03.027

Cited by 24 publications

(23 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[711] The intricate control of the central and peripheral nervous system on the urogenital organs would imply that POUR may occur with higher incidences in subpopulations of neurosurgical patients similar to those patients undergoing rectal or urological surgeries. Higher rates of PVR1 were seen in patients who underwent cervical or thoracic surgeries as opposed to cranial procedures.…”

Section: Discussionmentioning

confidence: 99%

The incidence and risk factors for postoperative urinary retention in neurosurgical patients

Alsaidi

Guanio²,

Basheer³

et al. 2013

Surg Neurol Int

View full text Add to dashboard Cite

Background:Postoperative urinary retention (POUR) is a common problem in adult neurosurgical patients. The incidence of POUR is unknown and the etiology has not been well established. POUR can lead to urogenital damage, prolonged hospital stay, higher cost, and infection. This study elucidates several risk factors that contribute to POUR in a variety of neurosurgical patients in one institution.Methods:A total of 137 neurosurgical patients were prospectively followed up for the development of POUR, which we defined as initial postvoid residual (PVR1) >250 ml 6 hours after removal of an indwelling urinary catheter (IUC). For patients with PVR >250 ml on the third check, IUCs were reinserted and kept in for 5-7 days.Results:Of the 137 patients, 68 (50%) were male, 41% (56/137) were 60 years or older, 86% (118/137) underwent spinal surgery, and 54% (74/137) had anesthesia over 200 minutes. Overall incidence of clinical POUR was 39.4% (54/137). Significantly higher rates of PVR1 >250 were noted in males, patients older than 60 years, and those who underwent spine surgery. When considering all patient characteristics (except selective alpha blockers), only gender, surgery time, and surgery type remained significant. In addition, PVR1 >250 was positively associated with longer length of stay. Of all patients, 24 (18%) had IUCs reinserted postoperatively or should have had one (5 refused and 2 had a third PVR). The association of IUC reinsertion with male gender was significant.Conclusion:Male gender, time of anesthesia >200 minutes, older age, and spinal surgery are the most significant risk factors associated with POUR in neurosurgical patients.

show abstract

Section: Discussionmentioning

confidence: 99%

The incidence and risk factors for postoperative urinary retention in neurosurgical patients

Alsaidi

Guanio²,

Basheer³

et al. 2013

Surg Neurol Int

View full text Add to dashboard Cite

show abstract

“…Theoretically, urinary symptoms such as voiding are associated with damage to the parasympathetic nerves, leading to detrusor denervation and decreased sensitivity of the bladder. Long-term improvement can be expected by a high degree of reversibility of partially damaged nerves and functional compensation by unimpaired nerve pathways [26,27]. …”

Section: Discussionmentioning

confidence: 99%

Sexual and urinary functioning after rectal surgery: a prospective comparative study with a median follow-up of 8.5 years

Doeksen

Gooszen

Duijvendijk

et al. 2011

Int J Colorectal Dis

View full text Add to dashboard Cite

PurposeThe purpose of this study was to prospectively compare rectal resection (RR) with colonic resection on sexual, urinary and bowel function and quality of life in both short-term and long-term.MethodsEighty-three patients who underwent RR were compared to 53 patients who underwent a colonic resection leaving the rectum in situ (RIS). A questionnaire assessing sexual, urinary and bowel functioning with a quality of life questionnaire (SF-36) was sent to all participants preoperatively, 3 and 12 months postoperatively and approximately 8 years after the onset of the study.ResultsShort-term dysfunction included diminished sexual activity in female RR patients at 3 months and significantly more erectile dysfunction in RR patients 1 year postoperatively. Long-term dysfunction included more frequent and more severe erectile dysfunction in RR patients compared to RIS patients. These short-term and long-term outcomes did not influence overall quality of life. The incidence of urinary dysfunction was comparable between both groups. Bowel functioning was significantly better in the RIS group compared to the RR group 3 months and 1 year postoperatively.ConclusionsPatients who underwent RR experienced up to 1 year postoperatively more sexual and bowel function problems than RIS patients. However, short-term and long-term dysfunction did not influence overall quality of life. Erectile dysfunction in male RR patients persisted in time, whereas other aspects of sexual, urinary and bowel function after RR and colonic resection are similar after a median follow-up of 8.5 years.

show abstract

“…In case of postoperative urologic treatment for newly developed urinary dysfunction, primary endpoint is the increase of the IPSS by at least 5 points observed before urologic treatment compared to the preoperative IPSS. The primary endpoint is based on previous findings [ 16 ]. In a group of 61 patients undergoing mesorectal excision for rectal cancer we observed long-term urinary deterioration in 13 patients determined by the IPSS.…”

Section: Methodsmentioning

confidence: 99%

Continuous intraoperative monitoring of pelvic autonomic nerves during TME to prevent urogenital and anorectal dysfunction in rectal cancer patients (NEUROS): a randomized controlled trial

et al. 2016

View full text Add to dashboard Cite

BackgroundUrinary, sexual and anorectal sequelae are frequent after rectal cancer surgery and were found to be related to intraoperative neurogenic impairment. Neuromonitoring methods have been developed to identify and preserve the complex pelvic autonomic nervous system in order to maintain patients’ quality of life. So far no randomized study has been published dealing with the role of neuromonitoring in rectal cancer surgery.Methods/designNEUROS is a prospective two-arm randomized controlled multicenter clinical trial comparing the functional outcome in rectal cancer patients undergoing total mesorectal excision (TME) with and without pelvic intraoperative neuromonitoring (pIONM). A total of 188 patients will be included. Primary endpoint is the urinary function measured by the International Prostate Symptom Score. Secondary endpoints consist of sexual, anorectal functional outcome and safety, especially oncologic safety and quality of TME. Sexual function is assessed in females with the Female Sexual Function Index and in males with the International Index of Erectile Function. For evaluation of anorectal function the Wexner-Vaizey score is used. Functional evaluation is scheduled before radiochemotherapy (if applicable), preoperatively (baseline), before hospital discharge, 3 and 6 months after stoma closure and 12 months after surgery. For assessment of safety adverse events, the rates of positive resection margins and quality of mesorectum are documented.DiscussionThis study will provide high quality evidence on the efficacy of pIONM aiming for improvement of functional outcome in rectal cancer patients undergoing TME.Trial registrationClinicaltrials.gov: NCT01585727. Registration date is 04/25/2012

show abstract

Long-term urinary dysfunction after mesorectal excision: A prospective study with intraoperative electrophysiological confirmation of nerve preservation

Cited by 24 publications

References 29 publications

The incidence and risk factors for postoperative urinary retention in neurosurgical patients

The incidence and risk factors for postoperative urinary retention in neurosurgical patients

Sexual and urinary functioning after rectal surgery: a prospective comparative study with a median follow-up of 8.5 years

Continuous intraoperative monitoring of pelvic autonomic nerves during TME to prevent urogenital and anorectal dysfunction in rectal cancer patients (NEUROS): a randomized controlled trial

Contact Info

Product

Resources

About