[Erectile dysfunction after surgery for rectosigmoid tumors--diagnosis and therapy]

To assess the standard diagnostic and therapeutic algorithm of erectile dysfunction (ED) after radical operations on account of rectosigmoid tumours.

At the Faculty Hospital in Plzen from Jan. 1995 till Oct. 1999 the mentioned operation was implemented in 167 men, incl. 98 who were sent a questionnaire concerning postoperative sexual complaints. 39 replied. Those interested were examined further and treatment of ED was started.

Four men, mean age 75.3 +/- 1.0 years were before surgery sexually inactive. In the remaining 35 ED developed in 68.6% (24/35)--mean age 58.2 +/- 9.8 years (in men without ED it was 61.7 +/- 11.1 years), in 37.1% (13/35) ED was complete, in 31.4% (11/35) partial. A postoperative decline of libido was in recorded in 37.1% (13/35) and impaired ejaculation in 65.7% (23/35). In men with postoperative ED 66.7% (16/24) suffered also from another disease causing ED, in men without ED this ratio was only 18.1%. In the group of men with ED, on account of ED 40% were examined and treated (14/35) incl. 10 who were examined for the first time in conjunction with the questionnaire project. Sildenafil was administered to 10 men, an effect sufficient for intercourse was described by two (both with partial ED), a partial effect however inadequate for intercourse was described by four and four recorded no response. Only four men tried intracavernous PGE1 injections and in all instances with a favourable effect.

ED which affects about two thirds of patients is not treated as a rule. For examination a rule anamnestic data and physical examination are sufficient. Oral sildenafil treatment is effective only in a small percentage of patients. Intracavernous injections are more effective but are usually refused.