The long term effects of proctectomy on bladder function in patients with inflammatory bowel disease

The effect on bladder function of protectomy for colitis or Crohn's disease was studied by means of a questionnaire and by pressure/flow cystometry. Thirty‐seven patients who had undergone protectomy for inflammatory bowel disease were compared with 34 control patients who had undergone bowel resection without protectomy. Symptoms of urinary dysfunction were found to be significantly more common in patients after protectomy than in controls (P < 0·05). Straining at micturition (P < 0·05) and a sensation of incomplete emptying of the bladder (P < 0·02), in particular, were significantly more common after protectomy. Evidence of denervation of the bladder, as shown by the finding of capacious bladders with poor detrusor function, was found in 6 patients after protectomy but in none of the controls (P < 0·05). The residual volume of urine in the bladder after micturition was significantly greater in patients after proctectomy than in controls (P < 0·02). Thus, the bladder is at risk of denervation in the course of proctectomy for inflammatory bowel disease even when dissection is kept close to the rectum.