کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5660198 1407482 2017 12 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Séquelles génito-urinaires après résection rectale carcinologique. Que dire aux patients en 2017 ?
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های گوارشی
پیش نمایش صفحه اول مقاله
Séquelles génito-urinaires après résection rectale carcinologique. Que dire aux patients en 2017 ?
چکیده انگلیسی
Although we have seen revolutionary changes with multi-disciplinary management of patients with rectal cancer, the evaluation of genito-urinary sequelae remains of great concern. Precise preoperative evaluation with validated scores allows detection of urinary disorders in 16 to 23% of patients, and sexual disorders in nearly 35% of men and 50% of women. Regardless of the surgical approach, it is fundamental to respect the autonomic innervation during total mesorectal excision in order to prevent these sequelae. Identification of these nerves can be facilitated by intraoperative neuro-stimulation. In spite of these precautions, de novo urinary sequelae are observed in nearly 33% of patients and bladder evacuation disorders in 25% of patients. Advanced age, preoperative urinary disorders, female gender, and abdomino-perineal resection are independent risk factors for urinary sequelae. Early postoperative urodynamic abnormalities might be predictive of these sequelae and justify early physiotherapy. Likewise, sexual sequelae such as erectile and/or ejaculatory disorders, dyspareunia and lubrication deficits result in de novo cessation of sexual activity in 28% of men and 18% of women. Advanced age, neo-adjuvant radiation therapy, and abdomino-perineal resection are independent risk factors for sexual dysfunction. Pharmacotherapy with sildenafil has proven useful in the treatment of erectile disorders. Genito-urinary and ano-rectal sequelae occur concomitantly in more than one of ten patients, suggesting a potential common pathophysiology.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal de Chirurgie Viscérale - Volume 154, Issue 2, April 2017, Pages 99-110
نویسندگان
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