Question

Which of the following is the most common complication following ligation of the first vessel during abdominoperineal resection for rectal carcinoma?(APR Abdominoperineal resection)

• A. Parasympathetic-bladder dysfunction and retrograde ejaculation.
• B. Sympathetic - - bladder dysfunction and impotence.
• C. Sympathetic- retrograde ejaculation and bladder dysfunction.
• D. Sympathetic-Impotence and loss of cutaneous sensation in perineal region

Answer 1

The Correct Option is C

In the context of abdominoperineal resection (APR) for rectal carcinoma, understanding the complications related to nerve damage is crucial. When ligating blood vessels in this surgical procedure, it is possible to inadvertently affect the autonomic nerves, particularly those involved in pelvic functions.

Several nerves in the pelvic region control autonomic functions, with the sympathetic nerves being vital for certain bodily functions, including ejaculation and bladder control. Damage to these nerves can lead to complications. This brings us to the options provided:

1. Parasympathetic-bladder dysfunction and retrograde ejaculation.
2. Sympathetic - bladder dysfunction and impotence.
3. Sympathetic- retrograde ejaculation and bladder dysfunction.
4. Sympathetic-Impotence and loss of cutaneous sensation in perineal region.

In the context of APR and autonomic nerve injury:

• Sympathetic nerve damage primarily leads to retrograde ejaculation and bladder dysfunction. This occurs because these nerves facilitate normal seminal emission during ejaculation and also contribute to bladder control.

In conclusion, the most common complication related to the ligation of the first vessel during this procedure is:

Sympathetic- retrograde ejaculation and bladder dysfunction.