Matsumoto A, Okabe S, Yabata E, Nagamatsu H, Morita T, Endo M
First Department of Surgery, Tokyo Medical and Dental University, Japan.
Nihon Geka Gakkai Zasshi. 1995 Oct;96(10):680-4.
Disturbance of urinary bladder function occurs frequently after operations on rectal cancer. Clinical studies of 15 male patients with resected rectal cancers revealed a close relationship between the disturbance of urinary bladder function and the extent to which the autonomic nerves in the pelvis were disturbed. Clinically, transection of the hypogastric nerve did not affect urinary function. Branches to the urinary bladder in the pelvic plexus controlled bladder function bilaterally. Transection of one side of the pelvic splanchnic nerve (PSN) did not affect bladder function. Partial transection of the bilateral PSN strongly affected bladder function, but in these cases, compensation by the non-disturbed PSN improved urinary bladder function 3 months after the operation. It seems possible that the lower-grade branches to the urinary bladder in the PSN may control bladder function. Uroflowmetry, amount of residual urine, cystometry, and urinary bladder compliance were all useful in assessing disturbance of branches to the urinary bladder in the PSN. To assess the grade of severe Clinical cases, it proved the most convenient to examine the uroflowmetry and amount of residual urine.
直肠癌手术后膀胱功能障碍频繁发生。对15例接受直肠癌切除手术的男性患者进行的临床研究表明，膀胱功能障碍与盆腔自主神经受干扰的程度密切相关。临床上，腹下神经横断并不影响排尿功能。盆腔神经丛中支配膀胱的分支双侧控制膀胱功能。一侧盆内脏神经（PSN）横断不影响膀胱功能。双侧PSN部分横断对膀胱功能有强烈影响，但在这些病例中，未受干扰的PSN在术后3个月起到了代偿作用，改善了膀胱功能。PSN中支配膀胱的较低级分支可能控制膀胱功能。尿流率测定、残余尿量、膀胱测压和膀胱顺应性对于评估PSN中支配膀胱的分支的功能障碍均有帮助。为评估严重临床病例的程度，检查尿流率测定和残余尿量被证明是最方便的方法。
