[Urinary and sexual dysfunction after rectal cancer operation]

Using a questionnaire, the urinary function of 68 patients and the sexual function of 81 patients were evaluated after rectal cancer operation. The patients with carcinoma of the rectum suffered from severe damage to the urinary system following Miles' operation (Miles) which included 85.7% of the male and 42.9% female. On the other hand, 31.8% male and 33.3% female suffered following anterior resection or pull through operation (AR). Following Miles 64.3% male and 71.4% female had developed urinary incontinence while 36.4% male and 33.3% female developed the same following AR. These results indicate that dysfunction of the urinary voiding system was more common in the males while the females experienced urinary incontinence. This difference may be due to the severity of the surgical intervention to the bladder neck and partly to the anatomical difference of pelvic floor and of urethra. The recovery was poor in the patients who had developed disorder of the urinary voiding system and unfortunately 84% patients following Miles and 75% patients after AR could not return to normal voiding even five years after operation. Urinary incontinence persisted after Miles and after AR in 77.8% and 31% patient respectively. Sexual activity was remarkably reduced following Miles. The males lost the power of erection and ejaculation, the females suffered due to the existence of artificial colostomy. In order to maintain the normal physiological activity of the urogenital system following operation, it is important to avoid any damage preferably to the bladder neck and urethra in case of males and to avoid artificial stoma in females.