Male sexual function after autonomic nerve-preserving operation for rectal cancer.
OBJECTIVE
Sexual dysfunction after surgery of the rectum is a serious complication to male patients. Autonomic nerve-preserving operation for rectal cancer has been performed within the recent ten years to maintain urinary and male sexual functions without spoiling of therapeutic radicality. To clarify male sexual function as the degree of autonomic nerve-preserving operation, the function was outlined through clinical interview.


METHODS
In a series of 134 male patients who were undergoing autonomic nerve-preserving operation for rectal cancer, a detailed history of postoperative sexual function was obtained by interviews.


RESULTS
In 87.7 and 66.9 percent of patients, erectile and ejaculatory potencies were maintained, respectively, which were higher rates than those after extended and conventional pelvic dissections. According to the preserving extent of autonomic nerve, patients undergoing complete preserving operations showed higher rates of maintained erectile (92.9 percent) and ejaculatory functions (82.5 percent), sexual intercourse (89.9 percent), and orgasm (93.9 percent) compared with those undergoing hemilateral autonomic nerve-preserving (82.3, 47.1, 52.9, 64.7 percent) or partial pelvic plexus-preserving operation (61.1, 0, 26.3, 22.2 percent).


CONCLUSIONS
Pelvic plexus preservation is necessary to maintain erectile potency, and both hypogastric nerve and pelvic plexus preservation are necessary to maintain ejaculate function and orgasm. To maintain satisfactory sexual function, complete autonomic nerve-preserving operation is suitable.
Masui
H
H
Second Department of Surgery, Yokohama City University School of Medicine, Japan.
Ike
H
H
Yamaguchi
S
S
Oki
S
S
Shimada
H
H
D000368:Aged; D018572:Disease-Free Survival; D007172:Erectile Dysfunction / Q000209:etiology / Q000517:prevention & control*; D005500:Follow-Up Studies; D006801:Humans; D007001:Hypogastric Plexus / Q000601:surgery*; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010388:Pelvis; D012004:Rectal Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires