title: Comparative study of voiding and male sexual function following open and laparoscopic total mesorectal excision in patients with rectal cancer.
abstract: BACKGROUND
  This study aimed to compare voiding and male sexual dysfunction between open and laparoscopic rectal cancer surgery.
  
  
  METHODS
  Ninety-seven patients (62 male and 35 female) who underwent open (n = 41) or laparoscopic (n = 56) surgery for rectal cancer were prospectively enrolled. Urine flowmetry, the international prostate symptom score, and the international index of erectile function were assessed preoperatively and postoperatively.
  
  
  RESULTS
  Voiding function score increased 1 month after surgery (open: 9.3 ± 4.6 to 14.0 ± 8.2, laparoscopic: 8.3 ± 5.3 to 12.3 ± 5.2; P = 0.002 and P < 0.001). The score was even higher in both groups after 6 months, but the increases were not statistically significant (open: 9.9 ± 4.5, laparoscopic: 9.2 ± 5.6; P = 0.546 and P = 0.280). Male patients who underwent open surgery (n = 22) experienced declining sexual function until 12 months post surgery (before: 55.2 ± 9.8, 12 months: 48.7 ± 15.9, P = 0.031). In laparoscopic group (n = 28), sexual function decreased until 6 months after surgery, but rose again by 12 months (before: 55.4 ± 9.0, 12 months: 52.2 ± 11.7, P = 0.134).
  
  
  CONCLUSIONS
  Voiding dysfunction recovered after 6 months following both open and laparoscopic surgery. Male sexual function recovered more quickly in laparoscopic group and returned to preoperative levels after 12 months.
authors.affiliation: Department of Surgery, Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyuk
authors.initials: H
authors.lastname: Hur
authors.forename: Sung Uk
authors.initials: SU
authors.lastname: Bae
authors.forename: Nam Kyu
authors.initials: NK
authors.lastname: Kim
authors.forename: Byung Soh
authors.initials: BS
authors.lastname: Min
authors.forename: Seung Hyuk
authors.initials: SH
authors.lastname: Baik
authors.forename: Kang Young
authors.initials: KY
authors.lastname: Lee
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Young Deuk
authors.initials: YD
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D007081:Ileostomy; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D014554:Urination
keywords: laparoscopic surgery; rectal cancer; sexual function; total mesorectal excision; voiding function