Sexual function in men with rectal and rectosigmoid cancer after laparoscopic and open surgery

Postoperative sexual dysfunction is a serious problem in rectal cancer patients. Although laparoscopic surgery for rectal cancer is reportedly feasible, there are few studies comparing male sexual function after laparoscopic and after open surgery. The aim of this study was to investigate and compare the incidences and degrees of this complication between laparoscopic and open surgery for rectal cancer.

Male patients undergoing anterior resection for rectal cancer between 1994 and 2001 without recurrence were identified in a database. A retrospective analysis of sexual function before and after surgery was conducted using a postal questionnaire consisting of 5 questions regarding libido, erection, rigidity, ejaculation, and satisfaction.

Of 68 sexually active male patients who returned the questionnaires, 29 (42.6%) underwent laparoscopic surgery (LS) and 39 (57.4%), open surgery (OS). Each parameter was reduced following LS as well as OS. No significant difference was found between the changes in each score and the total score between LS and OS. According to univariate analysis, the lower tumor location was significantly associated with sexual dysfunction (p = 0.0111).

Male sexual dysfunction following laparoscopic surgery for rectal cancer is commensurate with that after open surgery. Lower tumor location is the only factor associated with male sexual dysfunction.