UROGENITAL SEQUELAE AFTER RADICAL RECTAL SURGERY: CLINICAL AND URODY'NAMIC STUDY'

Abstract

From the standpoint of quality of life, urinary and sexual dysfunctions were frequent sequelae and complications after treatment of carcinoma of the rectum either by surgery or surgery and postoperative irradiation. This work was done to study the Egyptian incidence of these sequelae and complications, and was carried out on two main groups. The first, is a retrospective group of 112 consecutive patients who underwent radical rectal resection for neoplastic lesions in the period from January 1990 to December 1992 (3 years); their records were carefully revised and analyzed. The second, is a prospective group of 70 selected patients, that were admitted to Ain Shams University Hospitals and National Cancer Institute in the period from July 1993 to January 1996 (2.5 years) for radical rectal surgery. The selected 70 patients (with normal lower urinary tract and sexual functions), who have started the plan of the prospective study in this work were classified according to the operation done into 3 groups: group I, rectal resection for benign lesions (20 patients); group II, abdominoperineal resection for malignant lesions (30 patients); group IIsIphincter saving resection for neoplastic lesions (20 patients). The selected 70 patients have been evaluated clinically, radiologically and urodynamically before the operation. Only 61 patients in the 3 groups have completed the full investigations at the 4th month after the operation; and 49 patients were followed up clinically up to one year after the operation. The surgical anatomy of the pelvis with especial emphasis on the nerve supply to urogenital organs was accurately described. Functional anatomy and physiology of urogenital system were discussed. Different types of radical rectal operations with stress on the mechanism and common sites of nerve injury during surgery were presented. The urodynamic