Initial Research On The Influence Of Urinary Function And Sexual Function After Pelvic Autonomic Nerves Preservation (PANP) And Total Mesorectal Excision (TME)

Objective:The surgical operation is the main therapy of rectal cancer.But after operation, Patients may unadvoidably get urinary and sexual functional disorder because of the pelvic nerve injury. Now TME is the gold standard of curing rectal cancer in the world. The purpose of the research analyze and evaluate influence Urinary function and sexual function with Pelvic Autonomic Nerves preservation after three months based on TME .Methods: From March 2004 to December 2007, Twenty-seven patients(17 male cases ,10 female cases ) with rectal cancer were performed with pelvic autonomic nerve preservation (PANP) and total mesorectal excision (TME) in our department . Controlled group (sixteen male cases) were performed with TME. The two groups of male examples are not difference in tumor location ,tumor stages adopt Dukes stages and the age. All examples haven't accepted radiotherapy and chemotherapy before operation. On the basis of TME principle, the operation segregates the paries posterior of rectum sharply. During the course the doctor should pay attention to the exact position of autonomic nerve; whether the tumor invades the nerves or metastasis, it determines whether retains the nerves. The main preservation nerves are :â‘ Superior hypogastric plexus nerve;â‘¡Hypogastric nerves;â‘¢Pelvic plexus;â‘£Pelvic splanchnic nerves. Observing the following contents:â‘ 23 patients(13 male cases ,10 female cases ) accepted TME+PANP preoperation, postoperation 3 months test urinary motivation and gather the consequence of the urinary flow rate, residual urine.â‘¡sexual function including ejaculation and erection, to know the erectile function by international index of erectile function and the function of ejaculation through questionnaire. The urinary function of preoperative and postoperative was compared by own control .Date were analyzed by"t"test or chi-square test . Male cases sexual functions of the experiment group(17 male cases) and the controlled group (16 male cases) were retrospectively analyzed by t test or chi-square test or Fisher's test.Result:â‘ The maximum urinary flow rate: the preoperative average is 24.1ml/s, the postoperative average is 23.8ml/s(within normal limits),the comparison of maximum urinary flow rat(et=-1.556, p=0.134); The comparison of residual urine(t=-2.576, p=0.141); All these differences mentioned above have no significance(p>0.05).â‘¡The indication sexual functions of the experiment group was better than the controlled group(p=0.033,0.032, all<0.05).Conclusions:The curative excision with PANP for advanced rectal cancer can reduce urinary and espcially sexual function disorder for male .