title: Urogenital function in robotic vs laparoscopic rectal cancer surgery: a comparative study.
abstract: OBJECTIVE
  Urological and sexual dysfunction are recognised risks of rectal cancer surgery; however, there is limited evidence regarding urogenital function comparing robotic to laparoscopic techniques. The aim of this study was to assess the urogenital functional outcomes of patients undergoing laparoscopic and robotic rectal cancer surgery.
  
  
  METHODS
  Urological and sexual functions were assessed using gender-specific validated standardised questionnaires. Questionnaires were sent a minimum of 6 months after surgery, and patients were asked to report their urogenital function pre- and post-operatively, allowing changes in urogenital function to be identified. Questionnaires were sent to 158 patients (89 laparoscopy, 69 robotic) of whom 126 (80 %) responded. Seventy-eight (49 male, 29 female) of the responders underwent laparoscopic and 48 (35 male, 13 female) robotic surgery.
  
  
  RESULTS
  Male patients in the robotic group deteriorated less across all components of sexual function and in five components of urological function. Composite male urological and sexual function score changes from baseline were better in the robotic cohort (p < 0.001). In females, there was no difference between the two groups in any of the components of urological or sexual function. However, composite female urological function score change from baseline was better in the robotic group (p = 0.003).
  
  
  CONCLUSIONS
  Robotic rectal cancer surgery might offer better post-operative urological and sexual outcomes compared to laparoscopic surgery in male patients and better urological outcomes in females. Larger scale, prospective randomised control studies including urodynamic assessment of urogenital function are required to validate these results.
authors: Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK. sofoklis_p@hotmail.com.|School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK. sofoklis_p@hotmail.com.
authors: Sofoklis
authors: http://orcid.org/0000-0003-3610-1201
authors: S
authors: Panteleimonitis
authors: Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.
authors: Jamil
authors: J
authors: Ahmed
authors: Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.
authors: Meghana
authors: M
authors: Ramachandra
authors: Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.
authors: Muhammad
authors: M
authors: Farooq
authors: School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.
authors: Mick
authors: M
authors: Harper
authors: Department of Minimally Invasive Colorectal Unit, Queen Alexandra Hospital NHS Trust, Portsmouth, UK.|School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.|Colorectal Cancer Unit, Champalimaud Clinical Foundation, Lisbon, Portugal.
authors: Amjad
authors: A
authors: Parvaiz
mesh_terms: D000368:Aged; D003710:Demography; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000503:physiopathology* / Q000601:surgery*; D012371:Robotics; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D014566:Urogenital System / Q000503:physiopathology*
keywords: Rectal cancer; Robotic surgery; Sexual function; Urogenital function; Urological function