Impact on sexual function of surgical treatment in rectal cancer

Abstract

IntroductionThe development of new surgical techniques and medical devices, like therapeutical multimodal approaches has allowed for better outcomes on patients with rectal cancer (RCa). Owing to that, an increased awareness and investment towards better outcomes regarding patients’ sexual and urinary function has been recently observed.AimEvaluate and characterize the sexual dysfunction of patients submitted to surgical treatment for RCa.Materials and MethodsAn observational retrospective study including all male patients who underwent a surgical treatment for RCa between January 2011 December 2014 (n=43) was performed, complemented with an inquiry questionnaire to every patient about its sexual habits and level of function before and after surgery.DiscussionAll patients were male, with an average of 64yo. (range 42-83yo.). The surgical procedure was a rectum anterior resection (RAR) in 22 patients (56%) and an abdominoperineal resection (APR) in 19(44%). Sixty three percent described their sexual life as important/very important. Sexual function worsening was observed in 76% (65% with complains on erectile function, and 27% on ejaculation). Fourteen patients (38%) didn't resume sexual activity after surgery. Increased age (p=0.007), surgery performed (APR) (p=0.03) and the presence of a stoma (p=0.03) were predictors of ED after surgery. A secondary analysis found that the type of surgery (APR) (p=0.04), lower third tumor's location (p=0.03) and presence of comorbidities (p=0.013) (namely, smokers and diabetic patients) were predictors of de novo ED after surgery.ConclusionsThis study demonstrated the clear negative impact in sexual function of patients submitted to a surgical treatment for RCa. Since it is a valued feature for patients, it becomes essential to correctly evaluate/identify these cases in order to offer an adequate therapeutical option.

Neoadjuvant radiotherapy for rectal cancer management

“…The type of surgical procedure was also related to worse outcomes ( P = 0.005) with most patients treated with APR reporting sexual dysfunction. Moreover, an observational retrospective study performed by Costa et al[49] in 2018 found the presence of a stoma post-operatively to be associated with sexual dysfunction. Attaallah et al[50] compared rates of sexual dysfunction in patients treated with laparoscopic TME and those treated with open TME in 187 patients and reported reduced rates of dysfunction in the laparoscopic arm compared to open.…”

Analysis of the Risk Factors for Sexual Dysfunction in Stoma Patients

“…Data on the characteristics of respondents in this study were diabetes mellitus 13.5%, respondents with hypertension 18.9%, the majority of respondents had a history of consuming drugs, namely 54%, where the most consumed drugs were MST 18 drugs, 9%, the majority of respondents with cancer namely 91.9% and the majority of respondents undergoing chemotherapy 91.9%. According to Costa et al diabetes, hypertension, and the use of sedatives are risk factors for sexual dysfunction (17) . The results of the bivariate analysis showed a significant relationship between biological factors and the incidence of sexual dysfunction in patients with a stoma (p = 0.00).…”

Farklı kültürlerde jinekolojik ve meme kanserli kadın hastaların seksüaliteye bakış açıları ve yaşadıkları sorunlar

“…[59] SONUÇ Sonuç olarak kanser, gerek hastalığın kendisi gerekse uygulanan tedaviler nedeniyle, birtakım fizyolojik değişimlere yol açmasının yanı sıra, bireylerin ve aile üyelerinin yaşam kalitesinin azalmasıyla ilişkili olarak depresyon, kaygı, benlik saygısının bozulması, stres, psikolojik ve duygusal refahta azalma gibi ciddi ve şiddetli psikososyal etkilere neden olmaktadır. [63][64][65][66][67][68] Bireyin fiziksel sağlık, psikolojik durum, bağımsızlık seviyesi, kişisel inançları, sosyal ilişkileri gibi varlığının tüm yönlerini kapsayan yaşam kalitesinin önemli bir boyutu olan cinsellik de bu süreçte çok boyutlu olarak etkilenmektedir. [66,69,70] Hakem Değerlendirmesi…”