Impact of laparoscopic surgery on bladder and sexual function after total mesorectal excision for rectal cancer

Asoğlu, Oktar; Matlim, Tugba; Karanlık, Hasan; Atar, Murat; Müslümanoğlu, Mahmut; Kapran, Yersu; İğci, Abdullah; Özmen, Vahit; Keçer, Mustafa; Parlak, Mesut

doi:10.1007/s00464-008-9870-7

Cited by 111 publications

(74 citation statements)

References 25 publications

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“…Erectile potency improved in 80% of patients treated with sildenafil compared with 17% of patients treated with placebo (Lindsey et al, 2002). To date, most experienced surgeons perform TME with preservation of the neurovascular bundles with improved reported rates of ED (Asoglu et al, 2009;Breukink et al, 2009;Kim et al, 2012;Pocard et al, 2002). However, only one prospective study conducted in Japan examined the outcome of postoperative treatment with sildenafil for potent male patients after TME for low rectal cancers (Nishizawa et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Phosphodiesterase-5 Inhibitors and Vacuum Erection Device for Penile Rehabilitation After Laparoscopic Nerve-Preserving Radical Proctectomy for Rectal Cancer: A Prospective Controlled Trial

et al. 2016

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The current study sought to clarify the role of phosphodiesterase type 5 inhibitors (PDE-5i) and a vacuum erection device (VED) in penile rehabilitation after laparoscopic nerve-preserving radical proctectomy (LNRP) for rectal cancer. Participants were assigned to one of the following arms-no-intervention, nightly use of sildenafil 25 mg for 3 months after surgery, or concurrent use of nightly sildenafil 25 mg/day for 3 months and a vacuum erection device (VED) 10 to 15 minutes/day for 3 months-in a nonrandomized fashion. All participants had a follow-up of over 12 months prospectively, and patients had baseline, 3-, 6-, and 12-month assessment based on the International Index of Erectile Function-5 (IIEF-5). Seventy-one cases were included in final analyses. In the no-intervention group, the mean baseline IIEF-5 score of 21.9 decreased rapidly to 5.0 at 3 months (p < .001), 9.2 at 6 months (p < .001), and stayed at 10.9 at 12 months (p < .001). In the single therapy group, the mean baseline IIEF-5 score of 22.4 decreased dramatically to 9.0 at 3 months (p < .001), 14.9 at 6 months (p = .005), and stayed at 15.1 at 12 months (p = .005). In the combined therapy group, the mean baseline IIEF-5 score of 23.0 decreased slightly to 15.0 at 3 months (p = .005), 18.0 at 6 months (p = .038), and maintained at 18.7 at 12 months (p = .163). Findings suggested an over 50% decline in the quality of erection function of the patients after LNRP. The early use of PDE-5i alone or combined use of PDE-5i and VED after LNRP maintained erectile function at 12 months.

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Section: Discussionmentioning

confidence: 99%

Phosphodiesterase-5 Inhibitors and Vacuum Erection Device for Penile Rehabilitation After Laparoscopic Nerve-Preserving Radical Proctectomy for Rectal Cancer: A Prospective Controlled Trial

et al. 2016

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“…5 Moreover, with the development of laparoscopy surgery, it is both safe and feasible to perform sphincter-preserving and autonomic nerve-preserving radical rectal cancer surgery. 19,20 We applied laparoscopic TME combined with sphincter-preserving operation in patients with ultralow rectal cancer. The satisfaction rates of patients about their defecation function reached 60.3%, 84.5% and 91.3% at 6, 12, and 24 months follow-up, respectively.…”

Section: Discussionmentioning

confidence: 99%

Application of laparoscopic total mesorectal excision combined with sphincter-preserving surgery in low or ultralow rectal cancer

Liu

Niu

et al. 2016

J. Innov. Opt. Health Sci.

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This study aimed to investigate the in°uence of laparoscopic total mesorectal excision combined with sphincter-preserving surgery on the postoperative defecation function, urinary function and sexual function in low or ultralow rectal cancer. A retrospective study was undertaken on 107 patients (65 laparoscopic resection and 42 laparoctomic resection) with rectal cancer undergoing laparoscopic or open laparoscopic total mesorectal excision combined with sphincter-preserving surgery from April 2009 to April 2013. The quality of life outcomes of all patients, including defection, urinary and sexual function, were assessed at 6, 12 and 24 months after operation. Gastrointestinal quality of life index (GQOLI) was used to evaluate the fecal incontinence and bowel dysfunction. Urinary and sexual functions were studied by means of questionnaires on the basis of the international prostatic symptom score (IPSS) and international index of erectile function (IIEF), respectively. In laparoscopic surgery group, there were two cases of anastomotic leakage, three cases of anastomotic stricture, seven cases of local recurrence, ten cases of hepatic metastasis and¯ve cases of lung metastasis. The satisfaction rates of patients about their defecation function reached 60.3% (35/58, 84.5% (49/58) and 91.3% (53/58) at 6, 12, and 24 months follow-up, respectively. The assessment after one year showed that the overall incidence of urinary dysfunction was 10.7% (7/65); Among male patients, 18.4% (7/36) su®ered from erectile dysfunction and 27.8% (10/36) su®ered from ejaculatory dysfunction; 65.5% (19/29) female patients investigated were satis¯ed with their postoperative sexual life. In open surgery group, there were two cases of anastomotic leakage, two cases of anastomotic stricture, nine cases of local recurrence, ten cases of hepatic metastasis and seven cases of lung metastasis. The satisfaction rates of patients about their defecation function were 56.4% (22/39), 82.1% (32/39) and 94.8% (37/39) at 6, 12, and 24 months follow-up, respectively. The assessment after one year showed * Corresponding author. This is an Open Access article published by World Scienti¯c Publishing Company. It is distributed under the terms of the Creative Commons Attribution 4.0 (CC-BY) License. Further distribution of this work is permitted, provided the original work is properly cited. that the overall incidence of urinary dysfunction was 11.9% (5/42); 25% (4/16) male patients su®ered from erectile dysfunction and 31.3% (5/16) su®ered from ejaculatory dysfunction; 69.2% (19/26) female patients investigated were satis¯ed of their postoperative sexual life. There was no statistic di®erence in the two groups. Laparoscopic total mesorectal excision combined with sphincter-preserving surgery in low or ultralow rectal carcinoma is safe and practicable. It can be helpful for enhancing the probability of anus reservation, and obtains satisfactory defecation, sexual and urinary functions.

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“…However, when an experienced surgeon performs the surgery, the laparoscopic approach allows for better visualisation of small structures, such as the pelvic autonomic nerves. Laparoscopy also has advantages over laparotomy due to the image magnification and the 30-degree angle eyepiece (1,17,23,26,30) . The sympathetic component is recognised in more than 90% of cases and the parasympathetic component in 53% to 96%; this variation is due to the deeper location of the latter component inside the pelvis (17,30) .…”

Section: Discussionmentioning

confidence: 99%

Urinary Dysfunction After Surgical Treatment for Rectal Cancer

Beraldo

Yusuf

Palma

et al. 2015

Arq. Gastroenterol.

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-Background -The impact on quality of life attributed to treatment for rectal cancer remains high. Deterioration of the urinary function is a relevant complication within that context. Objective -To detect the presence of urinary dysfunction and its risk factors among individuals underwent surgical treatment for rectal cancer. Methods -The present prospective study analyzed 42 patients from both genders underwent surgical treatment for rectal adenocarcinoma with curative intent. The version of the International Prostatic Symptom Score (IPSS) questionnaire validated for the Portuguese language was applied at two time-points: immediately before and 6 months after surgery. Risk factors for urinary dysfunction were analysed by means of logistic regression and Student's t-test. Results -Eight (19%) participants exhibited moderate-to-severe urinary dysfunction 6 months after surgery; the average IPSS increased from 1.43 at baseline to 4.62 six months after surgery (P<0.001). None of the variables assessed as potential risk factors exhibited statistical significance, i.e., age, gender, distance from tumour to anal margin, neoadjuvant therapy, adjuvant therapy, type of surgery, surgical approach (laparoscopy or laparotomy), and duration of surgery. Conclusion -This study identified an incidence of 19% of moderate to severe urinary dysfuction after 6 months surveillance. No risk factor for urinary dysfunction was identified in this population. HEADINGS -Rectal neoplasms. Neurogenic urinary bladder. Colorectal surgery. Neoadjuvant therapy. Hypogastric plexus.

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Impact of laparoscopic surgery on bladder and sexual function after total mesorectal excision for rectal cancer

Cited by 111 publications

References 25 publications

Phosphodiesterase-5 Inhibitors and Vacuum Erection Device for Penile Rehabilitation After Laparoscopic Nerve-Preserving Radical Proctectomy for Rectal Cancer: A Prospective Controlled Trial

Phosphodiesterase-5 Inhibitors and Vacuum Erection Device for Penile Rehabilitation After Laparoscopic Nerve-Preserving Radical Proctectomy for Rectal Cancer: A Prospective Controlled Trial

Application of laparoscopic total mesorectal excision combined with sphincter-preserving surgery in low or ultralow rectal cancer

Urinary Dysfunction After Surgical Treatment for Rectal Cancer

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