Bladder dysfunction after the rectal cancer surgery : urodynamic evaluation

Oh, Seung Joon; Park, Jae Gahb; Choe, Kuk Jin; Lee, Sang Eun

Abstract

Bladder dysfunction after radical rectal cancer surgery has been well known but there has not been sufficient objective data in Korea. We performed consecutive urodynamic study preoperatvely, postoperative tenth day and postoperativesixth month on 71 patients undergone radical rectal surgery. Compared with preoperative state. each urodynamic parameters changed significantly : maximal flow rate and average flow rate decreased ; voiding sense and residual urine volume increased ; bladder capacity, compliance and detrusor pressure decreased ; and maximal urethral pressure, functional urethral pressure and functional urethral length changed. All in all, we came out with the results that autonomic denervation was developed in 59 (83%) out of 71 in postoperative tenth day and 11 (28%) out of 39 in postoperative sixth month. Except for the residual urine volume and detrusor pressure, no significant recovery was observed in postoperative sixth month. Univariate analysis showed that sex, age, tumor size, distance from anal verge, stage, intraluminal tumor position and mode of operation had no significant influence on urodynamic parameters. However, the higher the stage, the more damages were found in multivariate analysis using logistic regression with correction of sex and age. Bladder dysfunction after rectal cancer operation is caused by partial autonomic denervation where urologic care is necessary, however as a whole, bladder dysfunction is considered to be a temporary change.