Sexual dysfunction after rectal surgery: a retrospective study of men without disease recurrence.
BACKGROUND
Sexual dysfunction is a frequent complication of visceral surgery after rectal resections as a result of carcinoma of the rectum.


OBJECTIVE
The purpose of our study is to assess the incidence and form of sexual dysfunction in our own population of patients.


METHODS
The study comprised all patients who had undergone surgery for carcinoma of the rectum at the Erlangen Surgery University Hospital, Germany, in the period 2000-04. All male patients were retrospectively surveyed and asked to complete standardized (International Index of Erectile Function 15) questionnaires regarding their pre- and postsurgical sexual function. One hundred and forty-five questionnaires could be analyzed. The statistical evaluation was conducted with aid of the SPSS statistics program. The univariate analysis was carried out with the chi-square test and the U-test (Mann-Whitney Test).


METHODS
Erectile dysfunction, libido, and ability to have and sustain ejaculation and orgasm (both before and after surgery in each case) were among the dependent variables when compiling the data. The impact various surgical procedures and radiochemotherapy had on the severity of the sexual dysfunctions was analyzed. The scope of the postoperative urological care given was also assessed.


RESULTS
Erectile dysfunction was confirmed in N=112 patients (77.3%) after surgery (P-value<0.001). Other parameters such as orgasm capacity (4.1% vs. 16.5%), ejaculation ability (1.4% vs. 12.4%) and libido (3.4% vs. 22%) also showed a marked deterioration postoperatively. Postoperative erectile dysfunction was present in 77% of the patients with a colostomy and in 88.5% of the patients who had received neoadjuvant radiation.


CONCLUSIONS
Male erectile dysfunction is a frequent complication after rectal resection as a result of carcinoma of the rectum. The high incidence of sexual dysfunctions results from the radical nature of the procedure and from additional radiation or colostomy therapy. These patients need accompanying urological care for treatment of their sexual dysfunction.
Zugor
Vahudin
V
Department of Urology, Ansbach Medical Center, Ansbach, Germany. Zugor@web.de
Miskovic
Ivica
I
Lausen
Berthold
B
Matzel
Klaus
K
Hohenberger
Werner
W
Schreiber
Mathias
M
Labanaris
Apostolos P
AP
Neuhuber
Winfried
W
Witt
Jörn
J
Schott
Günter E
GE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000601:surgery; D003125:Colostomy; D004542:Ejaculation / Q000502:physiology*; D007172:Erectile Dysfunction / Q000503:physiopathology*; D006801:Humans; D007989:Libido / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications / Q000503:physiopathology*; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000503:physiopathology*