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Sexual dysfunction after excision of the rectum.

T Zenico, W Neri, M Zoli

Acta Urologica Belgica

|January 1, 1989

Summary

Rectal amputation surgery rarely causes erectile dysfunction, but can affect sexual activity due to colostomy. Most patients maintained normal sexual function post-surgery.

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Area of Science:

Urology
Gastroenterology
Sexual Medicine

Background:

Rectal amputation, often due to carcinoma or ulcerative colitis, involves significant surgical intervention.
The impact of Miles resection on post-operative sexual function requires thorough investigation.

Purpose of the Study:

To evaluate sexual activity and erectile function in patients after rectal amputation.
To assess hormonal, vascular, and neurological parameters related to sexual health post-surgery.

Main Methods:

A cohort of 18 patients (average age 49) underwent rectal amputation (Miles resection or for colitis).
Post-operative assessments included questionnaires on sexual activity, hormonal assays (FSH, LH, prolactin, testosterone), penile Doppler flowmetry, sacral latency testing, and home use of a Jonas erectiometer.
Evaluations were conducted six months after surgery.

Main Results:

Most patients exhibited normal hormonal, vascular, and neurological parameters, indicating minimal erectile deficits.
Only one patient reported complete loss of erections.
Sexual intercourse quality decreased for some due to colostomy, impacting physical and psychological aspects of partner relations.
Spermatic fluid analysis revealed alterations: absent in 8, retrograde in 3, diminished in 6, and normal in 4 patients.

Conclusions:

Rectal amputation surgery generally preserves erectile function.
Colostomy presents a significant challenge to sexual activity, affecting both physical and psychological well-being.
Spermatic fluid alterations are common post-rectal amputation.

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