Anorectal, bladder, and sexual function in females following colorectal surgery for carcinoma.
BACKGROUND
The aim of this study was to establish the incidence of potential postoperative anorectal, bladder, and sexual dysfunction in women following excision of rectal cancer with total mesorectal excision (TME).


METHODS
All women who underwent a transabdominal rectal resection with TME for cancer between 2000 and 2003 were included. Women with a colonic resection for cancer during the same time period served as the control group. Exclusion criteria were strict. Standardized questionnaires were sent to all patients.


RESULTS
Twenty-six patients fulfilled the inclusion criteria and were evaluated. Fifteen patients had TME and 11 patients had colonic resection. The median Wexner score showed a higher rate of anal incontinence in the rectal group. The difference was due to a higher rate of severe incontinence in the rectal group. The King's Health Questionnaire showed normal urinary function in both groups. The Female Sexual Function Index showed worse sexual function in the rectal group, reaching statistical significance in the categories 'arousal' and 'lubrication'.


CONCLUSIONS
After rectal excision, the women showed impairment of their anorectal and sexual function. Urinary function was normal. This is in contrast to the incidence of urinary dysfunction in men observed by others. Our study indicates that women seem to have less functional problems when compared to literature data on dysfunction in male following rectal surgery for cancer.
Department of General and Visceral Surgery, Universitätsklinikum Aachen, Aachen, Germany. gboehm@ukaachen.de
G
G
Böhm
R
R
Kirschner-Hermanns
A
A
Decius
N
N
Heussen
V
V
Schumpelick
S
S
Willis
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology* / Q000601:surgery; D003082:Colectomy / Q000379:methods; D015179:Colorectal Neoplasms / Q000601:surgery*; D003672:Defecation / Q000502:physiology*; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications; D012007:Rectum / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D019529:Sexuality / Q000502:physiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology*