title: Pelvic organ function and quality of life after anastomotic leakage following rectal cancer surgery.
abstract: BACKGROUND
  There is a paucity of studies assessing the influence of anastomotic leakage after rectal cancer surgery on pelvic organ function and quality of life.
  
  
  METHODS
  Between 1995 and 2006, 500 patients underwent rectal resection for malignancies at a single institution. Thirty-six patients (7.2%) developed an anastomotic leakage postoperatively. Fifteen of these patients (41.6%) died during the follow-up period. A self-administering questionnaire including the International Index of Erectile Function, Female Sexual Function Index, Short Form-12 Health Survey, International Prostatic Symptom Score, International Consultation on Incontinence Questionnaire-Short Form, Vaizey Incontinence Score and Wexner Constipation Score was sent to all 21 alive patients. Patients with rectal cancer resection without leakage served as controls for each case and were matched by sex, age (±5 years), type of resection, and neoadjuvant therapy (yes/no).
  
  
  RESULTS
  Sixteen patients (76.2%) were available and were included in the analysis. The median follow-up time was 106.8 months (32.4-170.4). Fecal incontinence, constipation, and sexual function did not differ significantly between patients and controls (p = 0.1973, 0.1189, 0.8519, respectively). By contrast, urinary continence was impaired significantly in the leakage group (p = 0.0430) but not in control patients. The Quality of Life assessing Short Form-12 Health Survey reached no significant difference between both groups (p = 1.0000 and 0.1973).
  
  
  CONCLUSIONS
  Anastomotic leakage following anterior resection negatively aggravates urinary function but not fecal incontinence, constipation or sexual functions. The data indicate that patients experiencing anastomotic leakages can be relieved from the fear of gross pelvic floor function disturbances.
authors.affiliation: Department of Surgery, Medical University of Vienna, Vienna, Austria. stefan.riss@meduniwien.ac.at
authors.forename: Stefan
authors.initials: S
authors.lastname: Riss
authors.forename: Stefan
authors.initials: S
authors.lastname: Stremitzer
authors.forename: Katharina
authors.initials: K
authors.lastname: Riss
authors.forename: Martina
authors.initials: M
authors.lastname: Mittlböck
authors.forename: Michael
authors.initials: M
authors.lastname: Bergmann
authors.forename: Anton
authors.initials: A
authors.lastname: Stift
mesh_terms: D000368:Aged; D057868:Anastomotic Leak / Q000453:epidemiology*; D001317:Austria / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D052776:Female Urogenital Diseases / Q000453:epidemiology*; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases / Q000453:epidemiology*; D015995:Prevalence; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome