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

Options

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 the perineal region

Correct Answer

Sympathetic-retrograde ejaculation and bladder dysfunction

Explanation

During abdominoperineal resection, the inferior mesenteric artery (first vessel ligated) is accompanied by the superior hypogastric plexus (sympathetic nerves). Damage to these sympathetic nerves can lead to: 1) Bladder dysfunction (loss of bladder neck control), 2) Retrograde ejaculation (failure of bladder neck closure during ejaculation causing semen to flow backward into bladder), 3) Sexual dysfunction. The parasympathetic nerves (nervi erigentes) are responsible for erection and are usually preserved during careful dissection.

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