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Sexual dysfunction following rectal cancer surgery.

V Celentano1, R Cohen2, J Warusavitarne3

  • 1Department of Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Southwick Hill Rd, Portsmouth, PO6 3LY, UK. valeriocelentano@yahoo.it.

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|May 13, 2017
PubMed
Summary

Sexual and urological problems are common after rectal cancer surgery. Current evidence does not favor any surgical approach, highlighting the need for standardized assessment tools to evaluate sexual function post-surgery.

Keywords:
Colorectal surgeryErectile dysfunctionNerve sparing surgeryRectal cancerSexual dysfunction

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Area of Science:

  • Oncology
  • Urology
  • Surgical Innovation

Background:

  • Rectal cancer surgery frequently leads to sexual and urological issues, often inadequately addressed.
  • Urogenital function relies on autonomic nerves, with specific pelvic and abdominal regions vulnerable during colorectal surgery.
  • Understanding these risks is crucial for preserving nerve function and patient quality of life.

Purpose of the Study:

  • To systematically review the epidemiology of sexual dysfunction after rectal cancer surgery.
  • To detail the anatomical basis of nerve-preserving surgical techniques.
  • To evaluate evidence comparing open, laparoscopic, and robotic approaches for rectal cancer surgery regarding sexual function outcomes.

Main Methods:

  • A comprehensive literature search was conducted following PRISMA guidelines.
  • Databases searched included Medline, Scopus, Web of Science, Embase, and Cochrane Central.
  • Studies focused on sexual function in patients undergoing rectal surgery for cancer were included.

Main Results:

  • The incidence and prevalence of sexual dysfunction post-rectal cancer surgery have been increasingly studied over 30 years.
  • Reported prevalence rates of sexual dysfunction show significant heterogeneity, ranging from 5% to 90%.
  • No definitive evidence supports one surgical approach (open, laparoscopic, or robotic) over others for sexual function outcomes.

Conclusions:

  • Current evidence does not favor open, laparoscopic, or robotic surgery for preserving sexual function after rectal cancer surgery.
  • Prospective, standardized diagnostic tools are recommended for routine assessment of sexual function in these patients.
  • Further research is needed to establish optimal surgical strategies for minimizing sexual dysfunction.