Clin Colon Rectal Surg 2003; 16(1): 013-018
DOI: 10.1055/s-2003-39033
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Voiding Dysfunction after Pelvic Surgery

Mazen M. Abdelhady, Magdy M. Hassouna
  • Department of Urology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
Further Information

Publication History

Publication Date:
07 May 2003 (online)

ABSTRACT

Chronic pelvic pain is a challenging disease with different presenting symptoms, which may include voiding dysfunction, urine retention, constipation, dyschezia, and/or dyspareunia. This article reviews the surgical anatomy of the pelvic nervous system and describes the theories proposed to explain the pathophysiology of pelvic pain syndrome. We also provide an overview of the causes of voiding dysfunction after pelvic surgery and the preventive and treatment modalities for postoperative pelvic pain.

REFERENCES

  • 1 Banerjee S, Farrell R J, Lembo T. Gastroenterological causes of pelvic pain.  World J Urol . 2001;  19 166-172
  • 2 ACOG technical bulletin. Chronic pelvic pain, number 223.  Int J Gynecol Obstet . 1996;  54 59-68
  • 3 Hogston P. Irritable bowl syndrome as a cause of chronic pain in women attending a gynecology clinic.  Br Med J . 1987;  294 934-935
  • 4 Walker E A, Gelfand A N, Gelfand M D, Green C, Katon W J. Chronic pelvic pain and gynecological symptoms in women with irritable bowel syndrome.  J Psychosom Obstet Gynaecol . 1996;  17 39-46
  • 5 Paulson D F. The urinary system. In: Sabiston DC Jr, ed. Textbook of Surgery: The Biological Basis of Modern Surgical Practice, 15th ed Philadelphia: WB Saunders 1997: 1524-1552
  • 6 Gosling J. The structure of the bladder and urethra in relation to function.  Urol Clin North Am . 1979;  6 31-38
  • 7 Havenga K, DeRuiter M C, Enker W E, Welvaart K. Anatomical basis of autonomic nerve-preserving total mesorectal excision for rectal cancer.  Br J Surg . 1996;  83 384-388
  • 8 Juenemann K P, Lue T F, Schmidt R A, Tanagho E A. Clinical significance of sacral and pudendal nerve anatomy.  J Urol . 1988;  139 74-80
  • 9 Zermann D H, Ishigooka M, Doggweiler R, Schmidt R A. Postoperative chronic pain and bladder dysfunction: windup and neuronal plasticity-do we need a more neurological approach in pelvic surgery?.  J Urol . 1998;  160 102-105
  • 10 Hunt S P, Pini A, Evan G. Induction of c-fos-like protein in spinal cord neurons following sensory stimulation.  Nature . 1987;  328 632-634
  • 11 Dubner R. Neuronal plasticity and pain following peripheral tissue inflammation or tissue injury. In: Bond MR, Charlton VE, Woolf CJ, eds. Proceedings of the VIth World Congress of Pain Amsterdam: Elsevier 1991: 264-276
  • 12 Woolf C J. Windup and central sensitization are not equivalent.  Pain . 1996;  66 105-108
  • 13 Hylden J L, Nahin R L, Traub R J, Dubner R. Expansion of receptive fields of spinal lamina I projection neurons in rats with unilateral adjuvant-induced inflammation: the contribution of dorsal horn mechanisms.  Pain . 1989;  37 229-243
  • 14 Laird J M, Cervero F. A comparative study of the changes in receptive-field properties of multireceptive and nocireceptive rat dorsal horn neurons following noxious mechanical stimulation.  J Neurophysiol . 1989;  62 854-863
  • 15 Katz J, Kavanagh B P, Sandler A N. et al . Preemptive analgesia. Clinical evidence of neuroplasticity contributing to postoperative pain.  Anesthesiology . 1992;  77 439-946
  • 16 Wang J J, Ho S T, Liu H S, Tzeng J I, Tze T S, Liaw W J. The effect of spinal versus general anesthesia on postoperative pain and analgesic requirements in patients undergoing lower abdominal surgery.  Reg Anesth . 1996;  21 281-286
  • 17 Mannheimer J F, Lampe G N. Clinical Transcutaneous Electrical Nerve Stimulation. Philadelphia, PA: FA Davis 1984: 7-10
  • 18 Buchsbaum H J, Plaxe S C. The urinary tract and radical hysterectomy. In: Buchsbaum HJ, Schmidt JD, eds. Gynecologic and Obstetric Urology Philadelphia: W.B. Saunders 1993
  • 19 Artman L E, Hoskins W J, Bibro M C. et al . Radical hysterectomy and pelvic lymphadenectomy for stage IB carcinoma of the cervix: 21 year experience.  Gynecol Oncol . 1987;  28 8-13
  • 20 Bandy L C, Clarke-Pearson D L, Soper J T, Mucth D G, MacMillan J, Creasman W T. Long-term effects on bladder function following radical hysterectomy with and without postoperative radiation.  Gynecol Oncol . 1987;  26 160-168
  • 21 Neal D E, Williams N S, Johnston D. A prospective study of bladder function before and after sphincter-saving resections for low carcinoma of the rectum.  Br J Urol . 1981;  53 558-564
  • 22 Leveckis J, Boucher N R, Parys B T, Reed M W, Shorthouse A J, Anderson J B. Bladder and erectile dysfunction before and after rectal surgery for cancer.  Br J Urol . 1995;  76 752-756
  • 23 Rankin J T. Urological complications of rectal surgery.  Br Urol . 1969;  41 655-659
  • 24 Fowler J W. Bladder function following abdominoperineal excision of the rectum for carcinoma.  Br J Surg . 1973;  60 574-576
  • 25 Eickenberg H U, Amin M, Klompus W, Lich R. Urologic complications following abdominoperineal resection.  J Urol . 1976;  115 180-182
  • 26 Fowler J W, Bremner D N, Moffat L E. The incidence and consequences of damage to the parasympathetic nerve supply to the bladder after abdominoperineal resection of the rectum for carcinoma.  Br J Uro1 . 1978;  50 95-98
  • 27 Gerstenberg T C, Nielsen M L, Clausen S, Blaabjerg J, Lindenberg J. Bladder function after abdominoperineal resection of the rectum for anorectal cancer.  Ann Surg . 1980;  191 81-86
  • 28 Woodside J R, Crawford E D. Urodynamic features of pelvic plexus injury.  J Urol . 1980;  124 657-658
  • 29 Blaivas J G, Barbalias G A. Characteristics of neural injury after abdominoperineal resection.  J Urol . 1983;  129 84-87
  • 30 Pavlkis A J. Cauda equina and pelvic plexus injury. In: Krane RJ, Siroky ME, eds. Clinical Neuro-Urology, 2nd ed Boston: Little, Brown 1991: 333-344
  • 31 Justins D. Basic principles of chronic pain management. In: Campbell IN, ed. Pain-An Updated Review Seattle: IASP Press 1996: 255-267
  • 32 Saag K G, Criswell L A, Sems K M, Nettleman M D, Kolluri S. Low dose corticosteroids in rheumatic arthritis: a meta analysis of their moderate-term effectiveness.  Arthritis Rheumat . 1996;  39 1818-1825
  • 33 Onghena P, Van Houdenhove B. Antidepressant-induced analgesia in chronic non-malignant pain: a meta-analysis of 39 placebo controlled studies.  Pain . 1992;  49 205-219
  • 34 Mellegers M A, Furlan A D, Mailis A. Gabapentin for neuropathic pain: systematic review of controlled and uncontrolled literature.  Clin J Pain . 2001;  17 284-295
  • 35 Zhang W Y, Li Wan Po A. The effectiveness of topically applied capsaicin: a meta-analysis.  Eur J Clin Pharmacol . 1994;  46 517-522
  • 36 Robotham M. Topical analgesics agents. In: Fields HL, Liebeskind JC, eds. Pharmacological Approaches to the Treatment of Chronic Pain: New Concepts and Critical Issues Progress in Pain Research and Management. vol. 1. Seattle: IASP Press 1994: 211-227
  • 37 Cherry D A, Plummer J L, Gourlay G K, Coates K R, Odgers C L. Ketamine as an adjunct to morphine in the treatment of pain.  Pain . 1995;  62 119-121
  • 38 Savage S R. Opioid use in the management of chronic pain.  Med Clin North Am . 1999;  83 761-786
  • 39 Barbalias G A, Nikiforidis G, Liatsikos E N. Alpha blockers for the treatment of chronic prostatitis in combination with antibiotics.  J Urol . 1998;  159 883-887
  • 40 Zermann D, Ishigooka M, Schubert J, Schmidt R A. Perisphincteric injection of botulinum toxin type A. A treatment option for patients with chronic prostatic pain?.  Eur Urol . 2000;  38 393-399
  • 41 Zermann D H, Ishigooka M, Wunderlich H, Reichelt O, Schubert J. A study of pelvic floor function pre- and post-radical prostatectomy using clinical neuro-urological investigations, urodynamics and electromyography.  Eur Urol . 2000;  37 72-78
  • 42 Gilliland R, Heymen J S, Altomare D F, Vickers D, Wexner S D. Biofeedback for intractable rectal pain: outcome and predictors of success.  Dis Colon Rectum . 1997;  40 190-196
  • 43 Lampl C, Kreczi T, Klingler D. Transcutaneous electrical nerve stimulation in the treatment of chronic pain: predictive factors and evaluation of the method.  Clin J Pain . 1998;  14 134-142
  • 44 Doggweiler-Wiygul R, Blankenship J, MacDiarmid S A. Review on chronic pelvic pain from a urological point of view.  World J Urol . 2001;  19 160-165
  • 45 Everaert K, Devulder J, De Muynck M. et al . The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes.  Int Urogynecol J Pelvic Floor Dysfunct . 2001;  12 9-14
  • 46 Schmidt R A. Urodynamic features of the pelvic pain patient and the impact of neurostimulation on these parameters.  World J Urol . 2001;  19 186-193
    >