title: Critical analysis of the literature investigating urogenital function preservation following robotic rectal cancer surgery.
abstract: OBJECTIVE
  To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery.
  
  
  METHODS
  A comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: "rectal cancer" or "colorectal cancer" and robot* or "da Vinci" and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors.
  
  
  RESULTS
  Fifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726 (54%) patients had their urogenital function assessedviameans of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and three sexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions.
  
  
  CONCLUSIONS
  There seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required.
authors.affiliation: Sofoklis Panteleimonitis, Jamil Ahmed, Amjad Parvaiz, Department of Colorectal Surgery, Poole Hospital, Dorset BH15 2JB, United Kingdom.
authors.forename: Sofoklis
authors.initials: S
authors.lastname: Panteleimonitis
authors.affiliation: Sofoklis Panteleimonitis, Jamil Ahmed, Amjad Parvaiz, Department of Colorectal Surgery, Poole Hospital, Dorset BH15 2JB, United Kingdom.
authors.forename: Jamil
authors.initials: J
authors.lastname: Ahmed
authors.affiliation: Sofoklis Panteleimonitis, Jamil Ahmed, Amjad Parvaiz, Department of Colorectal Surgery, Poole Hospital, Dorset BH15 2JB, United Kingdom.
authors.forename: Mick
authors.initials: M
authors.lastname: Harper
authors.affiliation: Sofoklis Panteleimonitis, Jamil Ahmed, Amjad Parvaiz, Department of Colorectal Surgery, Poole Hospital, Dorset BH15 2JB, United Kingdom.
authors.forename: Amjad
authors.initials: A
authors.lastname: Parvaiz
keywords: Colorectal surgery; Humans; Neurogenic; Physiological; Rectal neoplasms; Robotic surgical procedures; Sexual dysfunction; Urinary bladder