Preservation of sexual and bladder function after laparoscopic rectal surgery

Area of Science:

• Colorectal surgery
• Minimally invasive surgery
• Urology

Background:

• Concerns exist regarding higher rates of bladder and sexual dysfunction after laparoscopic rectal surgery compared to open surgery.
• This has prompted questions about the suitability of laparoscopic techniques for rectal procedures.

Purpose of the Study:

• To evaluate the incidence of bladder and sexual dysfunction in men following laparoscopic rectal surgery.
• To assess the functional outcomes of specific laparoscopic rectal procedures.

Main Methods:

• Retrospective analysis of a prospectively collected database from a single institution.
• Inclusion of 2406 patients undergoing laparoscopic colorectal surgery.
• Assessment of bladder function, potency, and ejaculation in male patients post-surgery.

Main Results:

• 101 male patients were identified for analysis (median age 62 years).
• 6% of patients reported urinary dysfunction.
• 6% of patients reported sexual dysfunction, including retrograde ejaculation and erectile dysfunction.

Conclusions:

• Low rates of sexual dysfunction may be due to experienced surgeons performing pelvic dissection.
• Laparoscopic restorative surgery for rectal cancer at this unit followed extensive experience with benign diseases and colon cancer.
• Poorer outcomes reported elsewhere might be linked to surgeons on their learning curve.