Urodynamic study of vesicourethral dysfunction following abdomino-perennial resection of the rectum for cancer

ABSTRACT

Vesico-urethral dysfunction following A.P.R. 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 spincter is the decisive factor for the proper management, while prostatic obstruction is the second factor. Cases of detrusor areflexia associated with a normal external spincterr have been successfully managed by urecholine therapy, but those who had prostatic obstruction in addition, needed T.U.R. prior to cholinergic stimulation. Cases with combined detrusor and external sphincter areflexia responded well to intermittent catheterization. Prostatectomy resulted in incontinence of urine in one of the cases with atonic external sphincter