Borschitz T, Kneist W, Junginger T
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität Mainz.
Chirurg. 2005 Jul;76(7):696-701; discussion 701-2. doi: 10.1007/s00104-004-0984-8.
Despite total mesorectal excision and protection of the pelvic autonomous nerve system, dysfunctions of the urinary bladder are often observed after surgical therapy for rectal cancer. In this prospective study, the frequency of urinary bladder malfunctions was assessed by measuring residual urine volume using transcutaneous ultrasound before and after surgery.
Seventy-five patients with rectal cancer were analyzed for urine volume retained before and after surgical therapy. The tumors were localized in the lower third of the rectum for 31 patients, in the middle for 30, and in the upper third for 14.
An increase in retained urine of more than 100 ml was found in 12 patients (15%), and neurogenic bladder was diagnosed in two (3%). In female patients, urinary bladder malfunctions were significantly less frequent and severe.
The percutaneous assessment of urine volume retained in the bladder is suited for determining urinary bladder malfunctions after surgery. This method can serve to assess the quality of surgical treatment for rectal cancer. A standardized definition of relevant urinary bladder malfunctions is required.