Potential benefit of laparoscopic surgery for rectal cancer on postoperative male sexual function

Kondo, Akihiro; Tsukada, Yuichiro; Sasaki, Takeshi; Inoue, Masaharu; Masuda, Hitoshi; Suzuki, Yasuyuki; Ito, Masaaki

doi:10.1111/codi.15626

Cited by 4 publications

(8 citation statements)

References 38 publications

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“…Erectile dysfunction (ED) is a common complication that significantly affects the postoperative quality of life in patients with colorectal cancer (CRC). Despite significant advances in surgical techniques, ED may occur in approximately half of the male patients who undergo surgery for CRC [ 1 ]. It is mainly attributed to pelvic cavernous nerve injury (CNI), resulting in corporal smooth muscle fibrosis [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Lipopolysaccharide-preconditioned allogeneic adipose-derived stem cells improve erectile function in a rat model of bilateral cavernous nerve injury

Zhang

Nie

Yang

et al. 2022

Basic Clin. Androl.

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Background Erectile dysfunction (ED) often occurs due to cavernous nerve injury (CNI) after colorectal surgery. Cell-based therapies have great potential for the treatment of CNI-related ED; however, it needs to be optimised. In this study, we explored the therapeutic effects of lipopolysaccharide-preconditioned allogeneic adipose-derived stem cells (L-ADSCs) on CNI-induced ED in rats. Results The results of this in vitro study revealed that low-dose lipopolysaccharide could increase the viability of ADSCs, inhibit caspase 3 activation induced by hydrogen peroxide and promote cell migration. Compared with the ADSC supernatant, the L-ADSC supernatant could better reduce fibrosis in the corpus cavernosum smooth muscle cells induced by transforming growth factor-beta 1 protein. In the in vivo study, it was compared to ADSCs therapy, where the L-ADSCs therapy indicated that could better improve erectile function by increasing smooth muscle content and alleviating penile fibrosis in rats 2 weeks after CNI. The outcome may be related to the increase in the hepatocyte growth factor content in the corpus cavernosum and myelin basic protein in the major pelvic ganglion. Conclusions L-ADSC treatment may be a promising approach for restoring erectile function after CNI.

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Section: Introductionmentioning

confidence: 99%

Lipopolysaccharide-preconditioned allogeneic adipose-derived stem cells improve erectile function in a rat model of bilateral cavernous nerve injury

Zhang

Nie

Yang

et al. 2022

Basic Clin. Androl.

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“…Other obstacles to sexual function assessment include different criteria [12,26], follow-up duration [3,6], and characteristics of the study participants [39]. Limiting the participants by exclusively targeting those with a normal sexual function status preoperatively is controversial.…”

Section: Discussion and Con Clus Ionsmentioning

confidence: 99%

“…The IIEF5 [23] consists of five items related to erection and sexual intercourse out of the 15 items of the IIEF, and each item is rated on a five-point scale, with a total possible score of 5-25; a higher score indicates a better function. The IIEF5 and IIEF scores were calculated and evaluated longitudinally using the preoperative and postoperative (3,6 and 12 month) questionnaires. Erectile dysfunction was defined as a decrease in the IIEF5 score at 12 months postoperatively compared with the preoperative status.…”

Section: What Does This Paper Add To the Literature?mentioning

confidence: 99%

“…Damage to the sympathetic nervous system can result in altered ejaculation, such as retrograde or no ejaculation, while parasympathetic or mixed disturbances can result in erectile dysfunction [4, 5]. In addition, the surgery type [6, 7], ostomy creation [3], and neoadjuvant chemoradiotherapy (nCRT) [6] are reported risk factors for sexual dysfunction.…”

Section: Introductionmentioning

confidence: 99%

“…

The primary goal of surgery for rectal cancer is to achieve a cure; however, preserving anorectal, urinary and sexual function is a significant priority for patients. Due to the close proximity of the autonomic nerves in the pelvis to the mesorectum, defaecatory, urinary and sexual dysfunction have been reported after surgical procedures for rectal cancer [1][2][3]. Male sexual dysfunction is a frequent concern.

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confidence: 99%

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Risk factors for and longitudinal course of male sexual dysfunction after robotic rectal cancer surgery

et al. 2023

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Aim The aim of this work was to investigate the risk factors associated with the incidence of sexual dysfunction in patients who underwent robot‐assisted surgery with several treatment options, such as neoadjuvant chemoradiotherapy and lateral lymph node dissection, and clarify the longitudinal course of erectile function in risk groups. Method A total of 203 male patients who underwent robot‐assisted total mesorectal excision for rectal cancer between 2013 and 2019 were included. The risk factors for erectile and ejaculatory dysfunction as well as the longitudinal course of erectile function were retrospectively investigated in all cohorts and several risk groups, including those who underwent neoadjuvant chemoradiotherapy, lateral lymph node dissection and adjuvant chemotherapy. Erectile dysfunction was assessed using the International Index of Erectile Function and ejaculatory dysfunction was assessed using original questions. The survey was performed preoperatively and at 3, 6 and 12 months postoperatively. Results Erectile and ejaculatory dysfunction occurred in 46.8% and 15.7% of the patients, respectively. Multivariate analysis showed that neoadjuvant chemoradiotherapy was an independent risk factor for erectile dysfunction. Erectile function recovered longitudinally to the preoperative level overall, as well as in lateral lymph node dissection and postoperative adjuvant chemotherapy subgroups; however, recovery was poor in the neoadjuvant chemoradiotherapy group, even at 12 months postoperatively. Conclusion Neoadjuvant chemoradiotherapy was found to be a risk factor for erectile dysfunction after robot‐assisted surgery for rectal cancer. Erectile function recovered postoperatively in patients undergoing lateral lymph node dissection; however, those receiving neoadjuvant chemoradiotherapy showed poor recovery, even at 12 months postoperatively.

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Investigation of postoperative erectile dysfunction in colorectal surgery patients and comparison of results

Uçaner,

Buldanli,

Çimen

et al. 2024

Medicine

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Background: Although surgical treatment is curative for colorectal cancers, erectile dysfunction (ED) is one of the complications that affect the patient quality of life. The present study aimed to evaluate sexual dysfunction in patients who underwent anterior resection (AR) and low AR (LAR) surgery secondary to rectosigmoid pathologies in our clinic, to analyze the effective variables, and to compare the results. Methods: In the retrospectively designed study, male patients who underwent surgery for malignancy or other surgical pathologies in the General Surgery Clinic between January 2017 and December 2022 were examined. Female gender, patients under 18 years of age, and patients who refused to participate in the study were excluded. Results: The high age of the patient increased the risk of severe ED in the postoperative period. However, surgical technique, alcohol use, American Society of Anesthesiologists (ASA) score, and Clavien-Dindo class were not determinants in the presence of severe ED. Conclusion: ED is an emerging medical problem that affects patients who undergo colorectal surgery adversely both in social and psychological aspects. Discussions on the issue are still ongoing. Clinicians’ concerns can be addressed in the future as the number of prospectively designed studies involving more homogeneous and larger populations increases.

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Potential benefit of laparoscopic surgery for rectal cancer on postoperative male sexual function

Cited by 4 publications

References 38 publications

Lipopolysaccharide-preconditioned allogeneic adipose-derived stem cells improve erectile function in a rat model of bilateral cavernous nerve injury

Lipopolysaccharide-preconditioned allogeneic adipose-derived stem cells improve erectile function in a rat model of bilateral cavernous nerve injury

Risk factors for and longitudinal course of male sexual dysfunction after robotic rectal cancer surgery

Investigation of postoperative erectile dysfunction in colorectal surgery patients and comparison of results

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