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Der Chirurg

, Volume 76, Issue 7, pp 696–702 | Cite as

Sonographische Restharnbestimmung

Methode zur Beurteilung der Blasenfunktion nach operativer Therapie des Rektumkarzinoms
  • T. Borschitz
  • W. Kneist
  • T. JungingerEmail author
Originalien
  • 207 Downloads

Zusammenfassung

Einleitung

Trotz totaler Mesorektumexzision und Schonung der autonomen Beckennerven treten nach operativer Therapie des Rektumkarzinoms Blasenfunktionsstörungen auf. In einer prospektiven Erfassungsstudie sollte durch perkutane sonographische prä- und postoperative Restharnbestimmung die Häufigkeit von Blasenentleerungsstörungen erfasst werden.

Patientengut und Methodik

Bei 75 Patienten mit Rektumkarzinom (Tumorlokalisation: 31 Patienten unteres Rektumdrittel, 30 mittleres Drittel, 14 oberes Drittel) wurde prä- und postoperativ die Restharnmenge bestimmt.

Ergebnis

Eine Zunahme der Restharnmenge von mehr als 100 ml trat bei 12 (15%) Patienten auf, eine neurogene Blase bei 2 (3%). Bei Frauen waren die Häufigkeit und Schwere der Blasenentleerungsstörung signifikant geringer.

Schlussfolgerung

Die perkutane Bestimmung des Restharns ist geeignet, Blasenentleerungsstörungen postoperativ nachzuweisen. Sie kann zur Qualitätsbeurteilung der operativen Therapie des Rektumkarzinoms dienen. Voraussetzung ist eine einheitliche Definition relevanter Blasenentleerungsstörung.

Schlüsselwörter

Rektumkarzinom Totale Mesorektumexzision Restharn Blasenfunktionsstörung 

Evaluation of residual urine volume by ultrasound for detection of urinary bladder dysfunction after surgical therapy of rectal cancer

Abstract

Introduction

Despite total mesorectal excision and protection of the pelvic autonomous nerve system, dysfunctions of the urinary bladder are often observed after surgical therapy for rectal cancer. In this prospective study, the frequency of urinary bladder malfunctions was assessed by measuring residual urine volume using transcutaneous ultrasound before and after surgery.

Patients and methods

Seventy-five patients with rectal cancer were analyzed for urine volume retained before and after surgical therapy. The tumors were localized in the lower third of the rectum for 31 patients, in the middle for 30, and in the upper third for 14.

Results

An increase in retained urine of more than 100 ml was found in 12 patients (15%), and neurogenic bladder was diagnosed in two (3%). In female patients, urinary bladder malfunctions were significantly less frequent and severe.

Conclusions

The percutaneous assessment of urine volume retained in the bladder is suited for determining urinary bladder malfunctions after surgery. This method can serve to assess the quality of surgical treatment for rectal cancer. A standardized definition of relevant urinary bladder malfunctions is required.

Keywords

Rectal cancer Total mesorectal excision Residual urine volume Bladder dysfunction 

Notes

Interessenkonflikt:

Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen.

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Copyright information

© Springer Medizin Verlag 2005

Authors and Affiliations

  1. 1.Klinik und Poliklinik für Allgemein- und AbdominalchirurgieJohannes-Gutenberg-Universität Mainz
  2. 2.Klinik für Allgemein- und AbdominalchirurgieKlinikum der Johannes-Gutenberg-UniversitätMainz

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