title: Male sexual function after total mesorectal excision: a comparison between laparoscopic and open surgery during the learning curve period.
abstract: BACKGROUND
  This study assessed male sexual function using a specific and validated questionnaire, the International Index of Erectile Function (IIEF), in patients subjected to open total mesorectal excision (OTME) and laparoscopic total mesorectal excision (LTME) and compared it with a control group.
  
  
  METHODS
  The inclusion criteria consisted of male patients with an active sexual life before surgery subjected to OTME or LTME at the Coloproctological Unit of the Clinics Hospital, Minas Gerais Federal University, between January 2005 and September 2009. The IIEF questionnaire was used. The control group comprised 30 randomly selected men (older than 35 y of age) without previous pelvic or abdominal surgery and without any genitourinary complaints.
  
  
  RESULTS
  Between January 2005 and September 2009, 77 male patients were subjected to total mesorectal excision, with 26 meeting the inclusion criteria and answering the questionnaire: 13 in the OTME group and 13 in the LTME group. When the 3 groups were compared in each IIEF domain, there were significant differences in erectile function (P=0.05), orgasm and ejaculation (P=0.009), sexual intercourse satisfaction (P=0.01), and overall satisfaction (P=0.025), favoring the LTME and control groups. No difference was found in sexual desire (P=0.285).
  
  
  CONCLUSIONS
  LTME may have the benefit of preserving male sexual function compared with OTME, even in the learning curve period.
authors.affiliation: *Department of Urology, São José University Hospital †Department of Surgery, Alpha Institute of Gastroenterology and Surgery of the Clinics Hospital ‡Department of Surgery, College of Medicine of the Minas Gerais Federal University (UFMG), Minas Gerais, Brazil.
authors.forename: Ricardo Gonçalves
authors.initials: RG
authors.lastname: Alvim
authors.forename: Fábio Lopes
authors.initials: FL
authors.lastname: de Queiroz
authors.forename: Antônio
authors.initials: A
authors.lastname: Lacerda-Filho
authors.forename: Rodrigo Gomes
authors.initials: RG
authors.lastname: da Silva
mesh_terms: D000328:Adult; D003082:Colectomy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D059032:Learning Curve; D008297:Male; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D019529:Sexuality / Q000502:physiology*; D011795:Surveys and Questionnaires