title: Male sexual function and lower urinary tract symptoms after laparoscopic total mesorectal excision.
abstract: OBJECTIVE
  The aim of this study was to investigate sexual function and the presence of lower urinary tract symptoms (LUTS) in male patients with rectal cancer following short-term radiotherapy and laparoscopic total mesorectal excision (LTME) by physical and psychological measurements.
  
  
  METHODS
  Sexual function and LUTS were assessed by the use of questionnaires [International Index of Erectile Function (IIEF), International Prostate Symptom Score]. Sexual function was further assessed by the use of pharmaco duplex ultrasonography of the cavernous arterial blood flow and nocturnal penile tumescence and rigidity monitoring (NPTR). All investigations were performed prior to the start of preoperative radiotherapy and 15 months after surgery.
  
  
  RESULTS
  Nine patients (mean age 60 years) participated. Erectile function was maintained in 71% and ejaculation function in 89%. Compared with pre-operative scores on the IIEF, a significant deterioration in intercourse satisfaction was seen following radiotherapy and LTME (7.9 vs 10.3, p = 0.042), but overall satisfaction remained unchanged (8.0 vs 7.0, p = 0.246). NPTR parameters (duration of erectile episodes, duration of tip rigidity > or =60%) decreased following radiotherapy and LTME. Patients reported a deterioration in micturition frequency (2.0 vs 1.0, p = 0.034) and quality of life due to urinary symptoms (8.0 vs 1.8, p = 0.018).
  
  
  CONCLUSIONS
  Based on these first preliminary findings, data suggest that 15 months after short-term radiotherapy and LTME in men with rectal cancer, objectively assessed sexual dysfunction was considerable, but overall sexual satisfaction had not changed.
authors.affiliation: Department of Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. sbreukink@msn.com
authors.forename: S O
authors.initials: SO
authors.lastname: Breukink
authors.forename: M F
authors.initials: MF
authors.lastname: van Driel
authors.forename: J P E N
authors.initials: JP
authors.lastname: Pierie
authors.forename: C
authors.initials: C
authors.lastname: Dobbins
authors.forename: T
authors.initials: T
authors.lastname: Wiggers
authors.forename: W J H J
authors.initials: WJ
authors.lastname: Meijerink
mesh_terms: D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology*; D010413:Penis / Q000000981:diagnostic imaging; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D011795:Surveys and Questionnaires; D018616:Ultrasonography, Doppler, Duplex; D014553:Urinary Tract Physiological Phenomena; D014555:Urination Disorders / Q000209:etiology