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Published on: February 12, 2022
Male sexual function after laparoscopic total mesorectal excision.
K Hida1, S Hasegawa, Y Kataoka
1Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Summary
Male sexual dysfunction after laparoscopic total mesorectal excision (LTME) is low. However, inadvertent pelvic autonomic nerve (PAN) injury during LTME can cause temporary sexual dysfunction, highlighting the need for careful surgical technique.
Area of Science:
- Colorectal Surgery
- Oncology
- Urology
Background:
- Laparoscopic total mesorectal excision (LTME) is a standard surgical procedure for rectal cancer.
- Sexual dysfunction is a potential complication following LTME due to proximity of pelvic autonomic nerves (PAN).
Purpose of the Study:
- To determine the frequency of male sexual dysfunction after LTME.
- To assess the impact of PAN preservation on sexual function outcomes.
Main Methods:
- Prospective study including patients undergoing LTME.
- Detailed video review to assess PAN preservation status.
- International Index of Erectile Function (IIEF) questionnaire administered pre-operatively and at 3, 6, and 12 months post-operatively.
Main Results:
- 11 out of 26 patients (41%) experienced inadvertent PAN damage.
- Patients with incomplete PAN preservation showed transient decreases in IIEF scores at 3 and 6 months.
- No significant long-term sexual dysfunction was observed at 12 months, with most patients recovering erectile function.
Conclusions:
- The overall rate of sexual dysfunction after LTME is low.
- Inadvertent PAN injury, detectable via enhanced laparoscopic visualization, is associated with temporary sexual dysfunction.
- Meticulous surgical technique and nerve preservation are crucial for maintaining sexual function post-LTME.
