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Impact on sexual function of surgical treatment in rectal cancer
Pedro Costa1, João M Cardoso2, Hugo Louro2
1Departmento de Urologia, Centro Hospitalar Vila Nova de Gaia, Espinho, Portugal.
Introduction:
The development of new surgical techniques and medical devices, like therapeutical multimodal approaches has allowed for better outcomes on patients with rectal cancer (RCa). Owing to that, an increased awareness and investment towards better outcomes regarding patients' sexual and urinary function has been recently observed.
Aim:
Evaluate and characterize the sexual dysfunction of patients submitted to surgical treatment for RCa.
Materials And Methods:
An observational retrospective study including all male patients who underwent a surgical treatment for RCa between January 2011 December 2014 (n=43) was performed, complemented with an inquiry questionnaire to every patient about its sexual habits and level of function before and after surgery.
Discussion:
All patients were male, with an average of 64yo. (range 42-83yo.). The surgical procedure was a rectum anterior resection (RAR) in 22 patients (56%) and an abdominoperineal resection (APR) in 19(44%). Sixty three percent described their sexual life as important/very important. Sexual function worsening was observed in 76% (65% with complains on erectile function, and 27% on ejaculation). Fourteen patients (38%) didn't resume sexual activity after surgery. Increased age (p=0.007), surgery performed (APR) (p=0.03) and the presence of a stoma (p=0.03) were predictors of ED after surgery. A secondary analysis found that the type of surgery (APR) (p=0.04), lower third tumor's location (p=0.03) and presence of comorbidities (p=0.013) (namely, smokers and diabetic patients) were predictors of de novo ED after surgery.
Conclusions:
This study demonstrated the clear negative impact in sexual function of patients submitted to a surgical treatment for RCa. Since it is a valued feature for patients, it becomes essential to correctly evaluate/identify these cases in order to offer an adequate therapeutical option.
Insights
Rectal cancer surgery significantly impacts sexual function, with 76% of male patients experiencing worsening erectile and ejaculatory function. Many patients do not resume sexual activity post-surgery, highlighting the need for better management strategies.
Area of Science:
- Oncology
- Urology
- Sexual Medicine
Background:
- Advancements in rectal cancer (RCa) treatment have improved patient outcomes.
- There is a growing focus on preserving sexual and urinary function post-RCa surgery.
Purpose of the Study:
- To evaluate and characterize sexual dysfunction in male patients after surgical treatment for RCa.
Main Methods:
- An observational retrospective study included 43 male patients who underwent RCa surgery.
- A questionnaire assessed sexual function before and after surgery.
Main Results:
- 76% of patients experienced worsened sexual function, including erectile dysfunction (65%) and ejaculation issues (27%).
- 38% of patients did not resume sexual activity post-surgery.
- Predictors of post-surgical erectile dysfunction included older age, abdominoperineal resection (APR), and stoma presence.
Conclusions:
- Surgical treatment for RCa has a significant negative impact on male sexual function.
- Identifying and managing sexual dysfunction is crucial for improving patients' quality of life.
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