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Patient-reported genitourinary dysfunction after laparoscopic and open rectal cancer surgery in a randomized trial
J Andersson1, G Abis, M Gellerstedt
1Scandinavian Surgical Outcomes Research Group, Department of Surgery, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Surgery, Alingsås Hospital, Alingsås, Sweden.
Laparoscopic and open surgery for rectal cancer similarly impact sexual dysfunction and urinary symptoms. While genitourinary function temporarily declines post-surgery, sexual function shows some recovery within a year, though male sexual problems may persist.
Area of Science:
- Oncology
- Surgical Innovation
- Patient-Reported Outcomes
Background:
- Rectal cancer treatment, including surgery, frequently leads to sexual dysfunction and micturition issues.
- Patient-reported outcomes are crucial for evaluating the long-term impact of surgical interventions for rectal cancer.
Purpose of the Study:
- To compare patient-reported sexual dysfunction and micturition symptoms after laparoscopic versus open surgery for rectal cancer.
- To assess the temporal changes in these symptoms following surgical treatment.
Main Methods:
- Utilized data from the COLOR II randomized trial comparing laparoscopic and open rectal cancer surgery.
- Administered the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CR38 questionnaire pre-surgery and at multiple follow-up points up to 24 months.
- Analyzed patient-reported outcomes, including sexual functioning, sexual enjoyment, sexual problems, and micturition symptoms, using adjusted mean differences.
Main Results:
- No significant differences in sexual dysfunction or micturition symptoms were observed between laparoscopic and open surgical groups.
- Genitourinary function decreased at 4 weeks post-surgery but improved over time, returning to baseline by 6 months for micturition symptoms.
- Erectile dysfunction affected a high percentage of men pre-surgery, increasing post-surgery, with persistent issues at 12 months, irrespective of surgical approach.
Conclusions:
- Laparoscopic surgery for rectal cancer does not alter the incidence or pattern of sexual dysfunction or micturition symptoms compared to open surgery.
- Sexual dysfunction is a common and often persistent issue for rectal cancer patients following surgical treatment.
- While micturition symptoms generally improve, sexual dysfunction remains a significant concern, highlighting the need for supportive care.
