title: Urinary and sexual disorders after laparoscopic TME for rectal cancer in males.
abstract: BACKGROUND
  Urinary and sexual dysfunctions are frequent after surgery for rectal cancer. Total mesorectal excision (TME) improves local recurrence and survival rates, and does not hamper recognition and sparing of hypogastric and pelvic splanchnic nerves. It is not known how laparoscopic rectal resection could change functional complication rates.
  
  
  METHODS
  From a global series of 1,216 laparoscopic interventions for colorectal diseases, 35 cases of males less than 70 years old, undergoing rectal resection and TME for a T1-3M0 medium and low rectal cancer were selected. Urinary and sexual functions after the operations were retrospectively recorded by means of specific tools (International Prostate Symptom Score (IPSS) and IIEF questionnaires, respectively).
  
  
  RESULTS
  None of the patients necessitated permanent or intermittent catheterization. More than half the patients had no complaints about urinary functions; about one third had nocturia; 72% of the patients had an IPSS less that 10, and no case of IPSS worse that 31 was recorded. Sexual desire was reduced and spontaneous erectile function was impaired in almost half the cases, while induced erections were possible in about 90% of cases; about 70% of patients still had the possibility of penetration and a normal ejaculation and orgasm after the intervention.
  
  
  CONCLUSIONS
  The present series confirms previous data and contribute to the creation of a benchmark specifically related to the laparoscopic approach to which surgeons should face when informing the patients before the operation. While severe urinary dysfunction is rare, sexual impairment remains a serious concern after rectal resection with TME.
authors.affiliation: U.O. Chirurgia Generale, Ospedale di Castelfranco Veneto, Treviso, Italy.
authors.forename: Carlo Augusto
authors.initials: CA
authors.lastname: Sartori
authors.forename: Alberto
authors.initials: A
authors.lastname: Sartori
authors.forename: Silvia
authors.initials: S
authors.lastname: Vigna
authors.forename: Rosario
authors.initials: R
authors.lastname: Occhipinti
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Baiocchi
mesh_terms: D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D010535:Laparoscopy; D007989:Libido; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D014555:Urination Disorders / Q000209:etiology*