Colorectal surgery and its impact on male sexual function

Area of Science:

• Colorectal surgery
• Oncology
• Urology

Background:

• Functional outcomes, particularly sexual function, are increasingly critical for colorectal cancer survivors.
• Sexual dysfunction is a prevalent issue post-treatment, despite advancements in oncologic outcomes.
• Surgical nerve damage, more than radiotherapy or chemotherapy, is the primary cause of sexual dysfunction.

Purpose of the Study:

• To detail the anatomy and pathophysiology of autonomic pelvic nerves relevant to sexual function.
• To review the prevalence of sexual dysfunction following colorectal cancer treatment.
• To describe surgical techniques for autonomic nerve preservation to maintain sexual function.

Main Methods:

• Review of anatomical and physiological principles of autonomic pelvic nerves.
• Analysis of literature on the prevalence of sexual dysfunction post-colorectal cancer treatment.
• Description of surgical techniques focusing on nerve preservation, including total mesorectal excision (TME) and laparoscopic approaches.

Main Results:

• Autonomic nerves are closely associated with the mesorectal fascia, making them vulnerable during rectal surgery.
• Total mesorectal excision (TME) has significantly improved autonomic nerve preservation.
• Laparoscopic surgery has demonstrated favorable results in preserving sexual function.

Conclusions:

• Understanding pelvic autonomic nerve anatomy is crucial for minimizing sexual dysfunction.
• Advanced surgical techniques like TME and laparoscopy are key to preserving sexual function after rectal cancer treatment.
• Continued focus on nerve preservation strategies is essential for improving the quality of life for colorectal cancer patients.