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January 1953

NEW CONCEPT OF VESICAL INNERVATIONRelationship of Vesical Innervation to Bladder Management Following Abdominoperineal Proctosigmoidectomy

Author Affiliations

From the Departments of Urology (Dr. McCrea, Clinical Professor) and Anatomy (Dr. Kimmel, Professor), Temple University School of Medicine and Temple University Hospital.

AMA Arch Surg. 1953;66(1):84-93. doi:10.1001/archsurg.1953.01260030095009

VESICAL dysfunction following some types of lower abdominal or pelvic surgery is known to occur occasionally. It is believed that this dysfunction is of neurogenic origin. In 1946 a theory of the causative factors of vesical dysfunction following abdominoperineal proctosigmoidectomy was presented.1 At that time it was stated that such dysfunction was believed to be of neurogenic origin and resulted from excision of the inferior hypogastric and pelvic plexuses; that the bladder responded as if a sympathetic nerve predominance existed; and that the return of bladder function was due to nerve regeneration. Many of these statements have been proved to be incorrect. It is still believed that vesical dysfunction following abdominoperineal proctosigmoidectomy is of neurogenic origin. However, in the interim since the previous report, basic research on the innervation of the bladder has been done. Through the medium of this research, it has been demonstrated that nerve fibers accessory

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