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Urinary complications following abdominal perineal resection
Author(s) -
Lapides Jack,
Tank Edward S.
Publication year - 1971
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197107)28:1<230::aid-cncr2820280147>3.0.co;2-a
Subject(s) - medicine , surgery , urinary retention , urethra , catheter , urinary bladder , urination , urinary system , cystometry , urology
Vesical dysfunction occurs in all patients immediately following operations upon the rectosigmoid and persists in 15% after several weeks. The cause for the immediate urinary retention is trauma to bladder, urethra, and associated nerve and blood supply. Persistent difficulty in micturition is usually due to previously existing prostatism in the male and atonic, large bladder in the infrequent voiding female. Permanent nerve damage is a rarc occurrence. Preoperative urogra‐ phy and, if indicated, endoscopy and cystometry are useful studies in predicting postoperative urinary complications. Appropriate therapy involves dependent, simple urethral catheter drainage of the bladder immediately after operation. Sepsis following urethral catheterization can be avoided by using a small caliber catheter in the male and preventing overdistention of the bladder in both male and female. Prostatectomy is indicated for the “prostatic” several weeks after the combined procedure, and a formal bethanechol chloride regimen is used to rehabilitate the atonic bladder. The diagnosis and principles of treatment of rarely occurring ureteral and urethral injuries are discussed.