[Sexual dysfunction following radical operation for cancer of the rectum and colon]

Sexual dysfunction frequently occurs following radical operation for cancer of intrapelvic organs. However, the number of impotent patients with colon and rectal cancer who actually visited our Reproduction Center complaining of impotence after operation accounted for only 31 (1.8%) out of the 1,686 impotent cases during past 8 years; of these 31 patients who complained of impotence after operation by Miles method, 79% were considered to suffer from organic impotence, while 62% of those having undergone anterior resection suffered organic impotence. Even in cases in whom no erection occurs due to some disorder in the nervous system, intracavernous injection treatment using vasoactive agents (papaverine or prostaglandin E1) can be effective if the vascular system is normal. In cases which do not react to this treatment, intrapenile transplantation of various silicone prostheses is tried. Moreover, administration of sympathomimetic agents (imipramine and so on) is undertaken in cases with retrograde ejaculation, among those with ejaculatory disorders, and if no effect is obtained by this administration, artificial insemination is tried using semen ejaculated into the bladder. In cases in whom no ejaculation occurs, even into the bladder, artificial ejaculation is attempted by spinal infusion of prostigmin, and when no effect is obtained, artificial insemination is tried using semen retained in an artificial spermatocele implanted in the tail of the epididymis.