Urodynamic study of vesico-urethral dysfunction following abdomino-perineal resection of the rectum for cancer

ABSTRACT

Vesicourethral dysfunction following APR in 14 cases out of 36 cases [39%] was studied urodynamically by combined pressure-flow and electromyography. Detrusor areflexia was found in all of the 14 cases, while the external sphincter was normal in 9 cases, areflexic in 3 cases and atonic in 2 cases. The functional status of the striated external sphincter is the decisive factor for the proper management. While, prostatic obstruction is the second factor. Cases of detrusor areflexia associated with a normal external sphincter have been successfully managed by urecholine therapy, but those who had prostatic obstruction in addition needed TUR prior to cholinergic stimulation. Cases with combined detrusor and external sphincter areflexia responded well to intermittent catheterization. Prostatectomy resulted in an incontinence of urine in one of the cases with atonic external sphincter