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Assessment of the Rectum and Anus01:25

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Sexual and urinary dysfunction following rectal dissection compared with segmental colectomy.

M T P R Perera1, K I Deen, S R E Wijesuriya

  • 1Department of Surgery, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka. tam-per@hotmail.com

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|February 26, 2008
PubMed
Summary

Rectal dissection surgery significantly impacts sexual and urinary function more than segmental colectomy in colorectal cancer patients. Men experienced greater impairment, with multifactorial causes affecting quality of life.

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Area of Science:

  • Colorectal surgery outcomes
  • Oncology patient rehabilitation
  • Surgical impact on quality of life

Background:

  • Colorectal cancer treatment often involves major abdominal surgery.
  • Rectal dissection and segmental colectomy are common surgical approaches.
  • Assessing postoperative functional outcomes is crucial for patient well-being.

Purpose of the Study:

  • To evaluate the impact of nerve-sparing surgery versus major abdominal surgery on sexual and urinary function.
  • To compare outcomes in men and women undergoing rectal dissection versus segmental colectomy for colorectal cancer.

Main Methods:

  • A comparative study involving 48 patients undergoing rectal dissection (Group A) and 24 patients undergoing segmental colectomy (Group B).
  • Preoperative data were collected and compared with age- and gender-matched controls (Group C).
  • Postoperative urinary and sexual function were assessed at 37 months.

Main Results:

  • Rectal dissection led to higher rates of urinary tract infections (31% vs 17.5%) and urinary dysfunction (60% vs 37.5%) compared to segmental colectomy.
  • Significant postoperative urinary symptoms (poor stream, incontinence, hesitancy) were noted after rectal dissection.
  • Sexual health was poorer after rectal dissection, with higher rates of erectile dysfunction in men and dyspareunia/reduced orgasm in women.

Conclusions:

  • Rectal dissection results in more significant urinary and sexual impairments in both men and women compared to segmental colectomy.
  • Men appear to be more affected by these functional deficits post-rectal dissection.
  • The etiology of these postoperative dysfunctions is multifactorial, necessitating further investigation.