High Rate of Sexual Dysfunction Following Surgery for Rectal Cancer

Abstract

PurposeAlthough rectal cancer is a very common malignancy and has an improved cure rate in response to oncological treatment, research on rectal-cancer survivors' sexual function remains limited. Sexual dysfunction (SD) after rectal cancer treatment was measured, and possible predisposing factors that may have an impact on the development of this disorder were identified.MethodsPatients undergoing curative rectal cancer surgery from January 2012 to September 2013 were surveyed using questionnaires. The female sexual function index or the International Index of Erectile Function was recorded. A multiple logistic regression was used to test associations of clinical factors with outcomes.ResultsFifty-six men (56%) and 28 women (44%) who completed the questionnaire were included in the study. A total of 76 patients of the 86 patients (90.5%) with the diagnosis of rectal cancer who were included in this study reported different levels of SD after radical surgery. A total of 64 patients (76%) from the whole cohort reported moderate to severe SD after treatment of rectal cancer. Gender (P = 0.011) was independently associated with SD. Female patients reported significantly higher rates of moderate to severe SD than male patients. Patients were rarely treated for dysfunction.ConclusionSexual problems after surgery for rectal cancer are common, but patients are rarely treated for SD. Female patients reported higher rates of SD than males. These results point out the importance of sexual (dys)function in survivors of rectal cancer. More attention should be drawn to this topic for clinical and research purposes.

Risk factors for sexual dysfunction after rectal cancer surgery in 948 consecutive patients: A prospective cohort study

“…The S 4 pelvic nerve and neuro-vascular bundles are thought to be associated with sexual function [1,26], which are more vulnerable to be injured when dissection planes should be low enough to the anastomosis, especially for male patients with a narrow pelvis. However, some studies even reported tumor location or level of anastomosis was not associated with sexual dysfunction [19,27], which may be due to the relatively small sample.…”

Male erectile function after treatment for colorectal cancer: a population‐based cross‐sectional study

“…Multiple studies have investigated EF after rectal surgery, but only a few have investigated EF after colonic surgery. In general, EF is negatively affected in rectal cancer survivors while only small changes are seen among colon cancer survivors compared with the background population [4,5,11,13,14].…”

“…Over the last decade, only few studies have addressed male sexual function following rectal cancer surgery [4,8,11,13,14]. Rectal surgery includes dissection close to the pelvic autonomic nervous system, which is of importance for the achievement of sufficient erectile function (EF) [4,5,11,12,15–19].…”

Survey on consenting practice and discussion of post-operative erectile dysfunction following rectal cancer surgery

“…Sexual dysfunction occurs frequently after rectal cancer surgery. [1][2][3][4] Total mesorectal excision (TME) carries a risk of impotence of between 10-50%. [4][5][6][7][8] This is because the pelvic autonomic nerves, which are responsible for normal urinary function and sexual function, are susceptible to damage during these procedures.…”