title: Sexual dysfunction after rectal surgery: a retrospective study of men without disease recurrence.
abstract: 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.
authors.affiliation: Department of Urology, Ansbach Medical Center, Ansbach, Germany. Zugor@web.de
authors.forename: Vahudin
authors.initials: V
authors.lastname: Zugor
authors.forename: Ivica
authors.initials: I
authors.lastname: Miskovic
authors.forename: Berthold
authors.initials: B
authors.lastname: Lausen
authors.forename: Klaus
authors.initials: K
authors.lastname: Matzel
authors.forename: Werner
authors.initials: W
authors.lastname: Hohenberger
authors.forename: Mathias
authors.initials: M
authors.lastname: Schreiber
authors.forename: Apostolos P
authors.initials: AP
authors.lastname: Labanaris
authors.forename: Winfried
authors.initials: W
authors.lastname: Neuhuber
authors.forename: Jörn
authors.initials: J
authors.lastname: Witt
authors.forename: Günter E
authors.initials: GE
authors.lastname: Schott
mesh_terms: 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*