Introduction. Low anterior resection of the rectum (LAR) is a treatment of choice in patients with diagnosed low rectal cancer. Rectal cancer surgery has a close relationship with the urinary-sexual organs and also with related nerves and nerve plexus. Thus, the sympathetic and parasympathetic nerves of the pelvic area may be damaged. As a result of this, the important point is the sexual function loss following rectal surgeries. The aim of the study was to investigate the sexual disorders in patients with rectal cancer who underwent LAR. Materials and methods. In this retrospective study the sexual activity, comfort of the experience, quality of sexual life (QoSL) during 3 periods were analyzed: before surgery, a month after and half a year after surgery. Analysis of demographic characteristics, comorbidities, previous surgeries, toumor characteristics and adjuvant therapy as was performed. Results. Most patients (64/100, 64%) expressed that LAR operation has strongly affected their QoSL, 32 patients reported the mild decrease in QoSL, while only 4 patients stated that did not experience any changes in QoSL. QoSL was assessed in 3 different periods of time: before the operation, 1 month after and 6 months after the operation (22,6±3.7 vs. 11.3±7,9 vs. 17,0±6.3; p<0.0001 respectively). The decreased QoSL one and six months after the surgery were significantly lower in patients with diagnosed hypertension and higher BMI (p=0.0283). Conclusions. Sexual disorders after LAR for rectal cancer are often underestimated and it is very important to be aware of them. In our study, it was determined that male sex, higher BMI and hypertension are related to impair of sexual dysfunction after LAR. We observed that the most severe complaints related to sexual activity occur one month after the procedure, after 6 months in most of the patients' sexual disorders were decreased approaching the initial state.

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The sex and age of the physician performing the digital rectal examination (DRE) procedure is one of the parameters influencing patients' comfort. It is postulated that the stress related to DRE during admission to the surgical ward may affect the compliance. the aim of the study was to characterize patients' preferences according to their sex, age, socioeconomic status and according to DRE-related variables. material and methods. Patients admitted to the Department of General and Colorectal Surgery at Medical University in Łódź between October 2014 and June 2015 were asked to complete a questionnaire regarding their sex, age, ethnic background, socioeconomic status and preference for a physician performing the DRE during admission to the surgical ward. results. The study enrolled 225 patients, 52% (n=117) women and 48% (n=108) men. Most patients 73.3% (n=244) expressed no preference for sex of the physician performing the DRE during admission, while 22.7% (n=51) preferred a same-sex physician. Analysis showed that the age, female sex, lower education status, small amount of comorbidities and number of hospitalizations, and no previous colonoscopy experience were all associated with preference for a same-sex physician. Conclusions. In our study most patients expressed no preference for sex of the physician performing the DRE during admission to the surgical ward. However, over one-tenth of patients reported such preferences. Most of these patients preferred a same-sex physician. It is important to offer these patients the choice of physician performing the DRE. Addressing patients' preferences may improve the atmosphere in the clinical environment, reduce stress, and facilitate better treatment.

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