Urinary and sexual dysfunction after rectal cancer treatment

Area of Science:

• Oncology
• Urology
• Surgical Science

Background:

• Improving rectal cancer survival rates highlight the need to address functional outcomes.
• Urogenital dysfunction is a prevalent issue post-rectal cancer treatment, affecting over half of patients sexually and one-third urinarily.
• Nerve damage during surgery is a primary cause of urinary issues, while radiotherapy may contribute to sexual dysfunction.

Purpose of the Study:

• To review the impact of rectal cancer treatment on urogenital function.
• To identify the causes and risk factors for sexual and urinary dysfunction after rectal cancer surgery.
• To propose strategies for improving functional outcomes in rectal cancer patients.

Main Methods:

• Review of large multicenter studies on rectal cancer treatment outcomes.
• Analysis of functional outcomes, specifically sexual and urinary function.
• Identification of surgical and therapeutic factors contributing to nerve damage and dysfunction.

Main Results:

• Over 50% of patients experience sexual dysfunction (ejaculatory problems, impotence, vaginal dryness, dyspareunia).
• Approximately one-third of patients report urinary dysfunction, primarily due to surgical nerve damage.
• Pelvic autonomic nerves are particularly vulnerable in low rectal cancer and abdominoperineal resection.

Conclusions:

• Urogenital dysfunction is a significant, common complication of rectal cancer treatment.
• Enhanced surgeon education in pelvic neuroanatomy and systematic nerve identification are vital for improving functional outcomes.
• Pre-operative patient counseling on risks and systematic functional status evaluation are recommended.