Risk factors for sexual dysfunction after rectal cancer treatment

A comprehensive longitudinal overview of health-related quality of life and symptoms after treatment for rectal cancer in the TME trial

“…However, when the sexual function of both PRT + TME and TME patients is compared to the general population, TME patients also reported a decreased sexual function [13,25] which implies that surgery is, besides RT, also an important cause of sexual dysfunction in rectal cancer survivors. Several studies even concluded that surgery is the main cause for sexual dysfunction [7,8]. Another source of possible bias is that only patients who responded to the HRQL questionnaire sent at 14 years are included in our analyses.…”

“…This was based on a previous study which reported that sexual dysfunction is primarily caused by surgery. The increase in sexual dysfunction was reported by patients at three months after surgery [7]. Although the use of these categories and patterns in this randomized setting are intuitive and straightforward in description, they cannot completely rule out possible confounders.…”

“…Most of the previous studies that assessed the HRQL and late side effects of rectal cancer survivors were cross-sectional. In these studies more bowel and sexual dysfunction was found after RT [4][5][6], although they concluded that sexual dysfunction was primarily caused by surgery [7]. In the few available longitudinal HRQL studies, the follow-up was at most until four years after treatment [8][9][10].…”

El cáncer colorrectal en la mujer

“…Aunque aproximadamente un tercio de las mujeres entre 50 y 70 años refieren ausencia de deseo sexual en condiciones normales, se estima que más de la mitad de las mujeres casadas mayores de 70 años continúan siendo sexualmente activas y más del 75% de ellas considera el sexo un aspecto importante de su vida personal (Avis et al, 2009;Beckman et al, 2008;Tan et al, 2009). La función sexual en las mujeres que han sido tratadas de un cáncer de recto puede verse afectada por múltiples causas, incluidas la pobre imagen corporal, la depresión, la pérdida de independencia, el daño de los nervios pélvicos del sistema autónomo por la cirugía o por la radioterapia, o el fallo hormonal ovárico inducido por la quimioterapia o la radioterapia (Bachmann y Leiblum, 2004;Donovan, Thompson y Hoffe, 2010;Grigsby et al, 1995;Havenga et al, 2000;Lange et al, 2009;Maas et al, 1998;Maurer et al, 2001;Ogilvy-Stuart y Shalet, 1993). La radioterapia puede además inducir atrofia y sequedad de mucosas, incluida la vaginal, fibrosis y adhesiones que en último término dificultan las relaciones sexua-a236 les o las hacen dolorosas.…”

Short-term outcomes of transanal completion total mesorectal excision (cTaTME) for rectal cancer: a case-matched analysis

“…With the implementation of population screening programs for colorectal cancer and longer life expectancy, the incidence of elderly patients being diagnosed with early rectal cancer increases. Rectal preserving therapy is appealing for these patients as radical rectal surgery has been correlated with higher colostomy rate, higher morbidity, and poorer functional outcomes [1][2][3][4][5][6][7][8]. Commonly used platforms for full-thickness local excision include transanal endoscopic microsurgery (TEM), transanal endoscopic operations (TEO) and the GelPoint® Path port which offer a safe and curative therapy when performed for large rectal adenomas and low-risk T1 carcinoma, including tumors smaller than 3 centimeters in size,…”