Male sexual and urinary function after laparoscopic total mesorectal excision.
BACKGROUND
Urinary and sexual dysfunction are potential complications of rectal surgery for cancer. This study retrospectively evaluated the frequency of such complications after laparoscopic total mesorectal excision (LTME) with autonomic nerve preservation.


METHODS
For this study, 50 men younger than 75 years who underwent radical LTME for mid and low rectal cancer were followed up for at least 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life.


RESULTS
Sexual desire was maintained by 55.6%, ability to engage in intercourse by 57.8%, and ability to achieve orgasm and ejaculation by 37.8% of the patients. Distance of the tumor from the anal verge and adjuvant or neoadjuvant treatments were the significant predictors of poor postoperative sexual function. Seven patients (14%) presented transitory postoperative urinary dysfunction, all of whom were medically treated. Tumor stage and distance from the anal verge were independently associated with the postoperative global International Prostatic Symptom Score (IPSS). No differences were observed in urinary quality of life.


CONCLUSIONS
In this series, LTME did not reproduce or improve on sexual and urinary dysfunction outcomes obtained in the best open TME series. Further trials are needed to evaluate functional outcome in rectal cancer patients.
Morino
Mario
M
Chirurgia Generale II, Center for Minimally Invasive Surgery, Department of Surgery, University of Turin, C.so A. M. Dogliotti, 14, 10126, Torino, Italy. mario.morino@unito.it
Parini
Umberto
U
Allaix
Marco Ettore
ME
Monasterolo
Gabriella
G
Brachet Contul
Riccardo
R
Garrone
Corrado
C
D000328:Adult; D000368:Aged; D003082:Colectomy / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology