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Related Concept Videos

Male Sexual Response: Erection & Ejaculation01:17

Male Sexual Response: Erection & Ejaculation

Sexual stimulation can take various forms, such as physical touch and visual or auditory cues. When this happens, the parasympathetic reflex in the sacral portion of the spinal cord is activated. This reflex stimulates the release of nitric oxide (NO), which then dilates the arterioles in the penis, increasing blood flow to the erectile tissues - the corpora cavernosa and corpus spongiosum.
The blood filling the erectile tissues compresses the veins, which helps to prevent blood from leaving...

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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
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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.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|July 11, 2012
PubMed
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.

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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.