Sexual dysfunction following rectal cancer surgery

Celentano, Valerio; Cohen, Richard; Warusavitarne, J; Faiz, Omar; Chand, Manish

doi:10.1007/s00384-017-2826-4

Cited by 70 publications

(55 citation statements)

References 81 publications

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“…However, postoperative erectile dysfunction (ED) can result from inadvertent axotomy of the pelvic cavernous nerve (CN) during surgical procedures. 1,2 Anatomical advances, and the advent of laparoscopic techniques, have reduced CN damage, but postoperative ED is still prevalent. 3 The CN is a parasympathetic nerve projected from the pelvic ganglion, which lies away from the target organ.…”

Section: Introductionmentioning

confidence: 99%

Co‐overexpression of VEGF and GDNF in adipose‐derived stem cells optimizes therapeutic effect in neurogenic erectile dysfunction model

Yang

Ouyang

et al. 2020

Cell Proliferation

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Objectives To evaluate the rapid repair potential of adipose‐derived stem cells (ADSCs) co‐overexpressing VEGF and GDNF on bilateral cavernous nerve injury (BCNI) in rat models. Progressive fibrosis of the penis that occurs shortly after BCNI is a key cause of clinical treatment difficulty of erectile dysfunction (ED). Traditional medications are ineffective for ED caused by BCNI. ADSCs have shown therapeutic effects in animal models, but disappointing in clinical treatment suggests that we should explore optimal treatment of it. Materials and methods We extracted ADSCs from rat epididymis. Lentiviral transfection was verified by western blot and immunofluorescence. Thirty‐six SD rats (10 weeks old) were randomly divided into six groups (n = 6 per group): sham surgery, and remaining five BCNI groups transplanted PBS or ADSCs which were genetically modified by vehicle, VEGF (ADSC‐V), GDNF (ADSC‐G), or VEGF&GDNF (ADSC‐G&V) around major pelvic ganglion (MPG). We investigated the therapeutic effects of BCNI rat model which is characterized by ED, penile tissue fibrosis and hypoxia, and lack of nitrogen nerves or vascular atrophy. Results Erectile function was almost recovered after 2 weeks of transplantation of ADSC‐G&V, promoted cavernous nerve repair, prevented penile fibrosis and preserving the vascular endothelium, which was significant differences amongst ADSC‐V or ADSC‐G. Moreover, GM‐ADSCs were detected in MPG and penis, indicating that their participation in repair of target organs and transverse nerves. Conclusions These promising data indicate that ADSCs co‐overexpressed VEGF and GDNF‐induced synergistic effects, make it a potential tool for recovering of erectile function speedily after BCNI.

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Section: Introductionmentioning

confidence: 99%

Co‐overexpression of VEGF and GDNF in adipose‐derived stem cells optimizes therapeutic effect in neurogenic erectile dysfunction model

Yang

Ouyang

et al. 2020

Cell Proliferation

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“…While preservation of these nerves is advocated, a review of sexual dysfunction following rectal cancer surgery did not find consistent evidence of any improvement in function or nerve preservation using minimally invasive techniques including laparoscopic and robotic surgery. 36 Some of the sexual side effects are reversible and treatable, but others are not, which makes preoperative discussion with patients of utmost importance.…”

Section: Resultsmentioning

confidence: 99%

Overlooked Long-Term Complications of Colorectal Surgery

Giglia

Stein

2019

Clinics in Colon and Rectal Surgery

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While colorectal surgery has been documented to have some of the highest complication rates in the surgical field, some of the more common, functional complications are often overlooked in the literature and in discussion with patients. Urinary, sexual, and defecatory dysfunction are common after colorectal surgery, especially after pelvic dissections, and may severely impact the postoperative quality of life for patients. These complications include urinary retention, erectile dysfunction, retrograde ejaculation, dyspareunia, infertility, and low anterior resection syndrome. The majority is rooted in autonomic nerve damage, both sympathetic and parasympathetic, that occurs during mobilization and resection of the sigmoid colon and rectum. While not all of these postoperative complications are preventable, treatment strategies have been developed to ameliorate the impact on quality of life. Given the high incidence and direct effect on patients, clinicians should be familiar with the etiology, prevention, and treatment strategies of these complications to provide the highest quality of care.

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“…Therefore, perirectal and perineal muscles should be avoided during dissection as long as possible, as the pudendal nerves pass through these muscles. Even partial preservation of pelvic nerves was reported to maintain sexual function (11,12). However, as seen in the study of Ameda and Hendren, erectile dysfunction remains a serious complication of rectal cancer surgery, even in nerve-sparing procedures (13).…”

Section: Discussionmentioning

confidence: 99%

Erectile dysfunction after surgery for rectal cancer: a prospective study

Gökçe

Özkan²

2019

Turk J Surg

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Objective: Erectile dysfunction may occur as a complication of surgical treatment of rectal cancer in male patients. We compared the rates of postoperative erectile dysfunction and response to medical treatment after low anterior resection (LAR) and Miles' procedures. Material and Methods: Fifty patients who underwent the Miles' procedure or LAR were prospectively assessed. This study includes fifty patients with stages 1 and stage 2 rectal cancer based on clinical and radiologic assessments, who underwent Miles' (25 out of 50 patients underwent the Miles'procedure and) or LAR (25 patients underwent LAR) procedures were prospectively assessed. The International Index of Erectile Function (IIEF) form was, used in the assessment to assess erectile dysfunction. This questionnaire, was administered preoperatively and 6 months postoperatively. For the patients with IIEF scores ≤ 25 at postoperative 6 th months, tadalafil 5 mg is was given for 12 weeks and IIEF is was repeated after then. Results: No significant differences were found in mean IIEF scores preoperatively (p= 0.695). In both groups, IIEF scores were significantly lower postoperatively compared with preoperatively (p= 0.00001, LAR; p= 0.00001, Miles'). Mean postoperative IIEF scores were significantly lower in patients who underwent Miles' compared with the LAR procedures (p= 0.0001). For patients with IIEF scores ≤ 25 at 6 months, tadalafil 5 mg was given for 12 weeks and IIEF scores were better in both groups (p= 0.00001). Conclusion: The erectile dysfunction rate after Miles' procedure was significantly higher than the rate of patients who developed erectile dysfunction after LAR surgery. We tried to emphasize that in after LAR surgery. We should not be concerned only with cancer treatment surgically in rectal tumour patients, but remember that situations affecting their social life, such as postoperative erectile dysfunction, have medical and psychologic importance.

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Sexual dysfunction following rectal cancer surgery

Abstract: There is no evidence to date in favor of any surgical approach (open vs laparoscopic vs robotic). Standardized diagnostic tools should be routinely used to prospectively assess sexual function in patients undergoing rectal surgery.

Cited by 70 publications

References 81 publications

Co‐overexpression of VEGF and GDNF in adipose‐derived stem cells optimizes therapeutic effect in neurogenic erectile dysfunction model

Co‐overexpression of VEGF and GDNF in adipose‐derived stem cells optimizes therapeutic effect in neurogenic erectile dysfunction model

Overlooked Long-Term Complications of Colorectal Surgery

Erectile dysfunction after surgery for rectal cancer: a prospective study

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