Korean J Urol.  2010 Dec;51(12):858-862.

Voiding and Sexual Function after Autonomic-Nerve-Preserving Surgery for Rectal Cancer in Disease-Free Male Patients

• Lee DK
• Jo MK
• Song K
• Park JW
• Moon SM

Abstract

PURPOSE
We evaluated the effects of surgery for rectal cancer on postoperative voiding and sexual function over the course of time.
MATERIALS AND METHODS
Data from 28 patients who underwent autonomic nerve preserving rectal cancer surgery were retrospectively analyzed. Operations were performed between October 2005 and July 2007 and all patients were followed-up for more than 3 years. Preoperatively, all patients underwent urodynamic studies including uroflowmetry, and filled out the International Prostate Symptom Score (IPSS). The evaluation of sexual function consisted of Erectile Function domain score in International Index of Erectile Function (IIEF-EFD) and Ejaculation domain score in Male Sexual Health Questionnaire (MSHQ-EjD). Data from uroflowmetry and questionnaires were examined.
RESULTS
At 3 years postoperatively the prostate volume was similar to the preoperative value (P=0.727). There were no statistically significant postoperative changes in the average maximum flow rate (15.9 ml/s vs. 16.2 ml/s, p=0.637) and post-void residual urine volume (34.7 ml vs. 36.8 ml, p=0.809). No statistically significant differences were observed in the IPSS (13.2 vs. 12.2, p=0.374). However, although pelvic autonomic nerve preservation have been performed, a significant proportion of rectal cancer patients suffer from sexual dysfunction and the average of IIEF-EFD and MSHQ-EjD scores was decreased postoperatively until 3 years (25.1 vs. 16.1 and 28.3 vs. 14.2 respectively, p<0.001).
CONCLUSIONS
Voiding function was not affected after autonomic nerve-preserving rectal cancer surgery, however sexual function was significantly aggravated. We recommend that the baseline genitourinary function should be evaluated before the treatment for male rectal cancer patients, and penile rehabilitation is necessary for their quality of life after treatment.

Keyword

Postoperative complications; Rectal neoplasms; Urination

MeSH Terms

Autonomic Pathways
Ejaculation
Humans
Male
Postoperative Complications
Prostate
Quality of Life
Rectal Neoplasms
Reproductive Health
Retrospective Studies
Urination
Urodynamics

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