Sexual function, incontinence, and wellbeing in women after rectal cancer--a review of the evidence.
BACKGROUND
Colorectal cancer (CRC) is the second most common cancer. One-third of these cancers occur in the rectum. Treatment of rectal cancer involves surgery with/without radiotherapy and chemotherapy. Surgery is undertaken to prevent damage to the nerves controlling bladder, bowel, and sexual organs, whether this translates into preservation of urinary and fecal continence and sexual function and, ultimately, quality of life (QoL) is not known.


OBJECTIVE
The aim of this review was to summarize the literature regarding the impact of treatment for rectal cancer on bladder and bowel continence, sexual function and QoL in women.


METHODS
A comprehensive review of the current literature on sexual function, incontinence and wellbeing in women after treatment for rectal cancer highlighting prevalence rates, trial design, and patient population.


METHODS
We conducted a systematic search of the literature using A systematic search of the literature using Medline (Ovid, 1946-present) and PubMed (1966-2011) for English-language studies that included the following search terms: "colorectal cancer," or "rectal cancer," or "rectal neoplasm," and "sexual function," or "sexual dysfunction," or "wellbeing," or "QoL," or "urinary or fecal incontinence."


RESULTS
Although around 1/3 of women aged 50 to 70 years report lack of sexual desire, sexual function problems after treatment for rectal cancer are in the order of 60% among women. QoL improves with length of survival. Urinary and fecal incontinence are ongoing concerns for many women after treatment with rates up to 60%.


CONCLUSIONS
There is a gap in our knowledge of the effects of rectal cancer and its treatment on urinary and fecal continence, sexual function and QoL in women. There is a need for studies of sufficient size and duration to gain a better understanding of the disease and its management and the long-term effects on these parameters. This information is needed to develop preventative health care plans for women treated for rectal cancer that target those most at risk for these adverse outcomes.
Women's Health Research Program, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. mary.panjari@monash.edu
Mary
M
Panjari
Robin J
RJ
Bell
Susan
S
Burney
Stephen
S
Bell
Paul J
PJ
McMurrick
Susan R
SR
Davis
D000368:Aged; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000523:psychology*; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000523:psychology; D014549:Urinary Incontinence / Q000453:epidemiology / Q000523:psychology*