Sexual dysfunction after curative radical resection of rectal cancer in men: the role of extended systematic lymph-node dissection.
BACKGROUND
This study was designed to determine the incidence and patterns of sexual dysfunction after curative radical resections (CRR) with or without extended systematic lymph-node dissection (ESLND) for rectal cancer Material/Methods: A total of 91 patients with rectal cancer were reviewed with respect to surgical procedures and postoperative sexual functions using the International Index of Erectile Function (IIEF), a 15-item self-administered questionnaire. CCR (abdomino-perineal resections or sphincter-saving anterior resections) was performed in 78 patients (Group I) and ESLND plus CRR in 13 patients (Group II), and sexual functions were also evaluated in the colostomy and non-colostomy subgroups.


RESULTS
In the postoperative period, the five domains of IIEF scoring decreased significantly from the preoperative scores in both groups (p<0.05), but the postoperative decreases were not significant between groups I and II (p>0.05). Having a permanent colostomy decreases IIEF scores in all colostomized patients.


CONCLUSIONS
CRR and CRR+ESLND both decrease sexual function and lymph-node dissection is not considered to have any additive effect on this decrease. In addition to standard surgery, anxiety about having a malignant disease and permanent colostomy may play an important role in male sexual dysfunction.
Cöl
Cavit
C
Department of General Surgery, Abant Izzet Baysal University Medical School, Bolu, and First Department of Surgery, Ankara Training Hospital, Turkey. col_c@ibu.edu.tr
Hasdemir
Oguz
O
Yalçin
Erol
E
Yandakçi
Kemal
K
Tunç
Gunduz
G
Kuçukpinar
Tevfik
T
D000328:Adult; D000368:Aged; D003125:Colostomy / Q000009:adverse effects; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D012004:Rectal Neoplasms / Q000601:surgery*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires