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Male sexual and urinary function after laparoscopic total mesorectal excision
Mario Morino1, Umberto Parini, Marco Ettore Allaix
1Chirurgia Generale II, Center for Minimally Invasive Surgery, Department of Surgery, University of Turin, C.so A. M. Dogliotti, 14, 10126, Torino, Italy. mario.morino@unito.it
Surgical Endoscopy
|October 16, 2008
Summary
Laparoscopic total mesorectal excision (LTME) for rectal cancer shows similar sexual and urinary dysfunction rates compared to open surgery. Further trials are needed to assess functional outcomes in these patients.
Area of Science:
- Colorectal Surgery
- Oncology
- Urology
Background:
- Rectal cancer surgery can lead to urinary and sexual dysfunction.
- Autonomic nerve preservation is crucial during rectal cancer surgery.
Purpose of the Study:
- To evaluate the frequency of sexual and urinary dysfunction after laparoscopic total mesorectal excision (LTME) with autonomic nerve preservation.
- To assess the impact of LTME on functional outcomes and quality of life in rectal cancer patients.
Main Methods:
- Retrospective evaluation of 50 male patients under 75 undergoing radical LTME for mid and low rectal cancer.
- Minimum 12-month follow-up including interviews and standardized questionnaires on functional outcomes and quality of life.
Main Results:
- Postoperative sexual function: 55.6% maintained sexual desire, 57.8% could engage in intercourse, 37.8% achieved orgasm/ejaculation.
- Predictors of poor sexual function included tumor distance from anal verge and neoadjuvant/adjuvant treatments.
- 14% experienced temporary urinary dysfunction, successfully treated medically. Tumor stage and distance correlated with IPSS.
Conclusions:
- LTME outcomes for sexual and urinary dysfunction are comparable to the best open TME series.
- Further clinical trials are necessary to fully evaluate functional outcomes in rectal cancer patients undergoing LTME.
