Sexual and urinary dysfunction following rectal dissection compared with segmental colectomy

Abstract

More patients after rectal dissection vs segmental colectomy had urinary tract infections [15 (31%) vs 3 (17.5%), P = 0.04]. At 37 months, urinary dysfunction after rectal excision was seen in 29 (60%; 20 men) vs nine (37.5%; eight men) after segmental colectomy. Postoperative urinary symptoms were significant in group A, but not in group B (pre: vs post; groups A and B: poor stream--13%vs 38%, P = 0.001 and 21%vs 21%, P = NS; incontinence--4.2%vs 17%, P = 0.008 and 8%vs 8%, P = NS; hesitancy--13%vs 35%, P = 0.034 and 17%vs 21%, P = NS). Sexual health was worse after rectal excision compared with segmental colectomy (men--62.5%, women--25%vs 44% of men) respectively. Erectile dysfunction was the chief cause (rectal excision--50%vs segmental colectomy - 33%). After rectal excision, 6% of women had dyspareunia and 19% reported reduced orgasm but none after segmental colectomy. Conclusion More men than women had urinary and sexual impairment after rectal excision than after segmental colectomy. Its aetiology is multifactorial.

Sexual Function in Colorectal Cancer Survivors

“…In another study, Quah et al 17 found a similar rate of erectile dysfunction, while 40% of men also reported an inability to ejaculate between 2 and 4 years after rectal excision. Among women, reported rates of dyspareunia vary from 6% at a median of 37 months after rectal excision 18 to more than 60% following abdominoperineal resection (APR) at a median of 52 months previously. 13 With respect to alterations in orgasm in women, rates range from 0% following segmental colectomy 18 to more than 30% following APR.…”

“…Among women, reported rates of dyspareunia vary from 6% at a median of 37 months after rectal excision 18 to more than 60% following abdominoperineal resection (APR) at a median of 52 months previously. 13 With respect to alterations in orgasm in women, rates range from 0% following segmental colectomy 18 to more than 30% following APR. 13 In a recent study among male and female CRC survivors who had undergone colon or rectal resection at least 1 year previously, 20% of colon cancer survivors and 5% of rectal cancer survivors reported sexual problems related to reduced sexual desire.…”

Urinary dysfunction after colorectal cancer treatment and its impact on quality of life – a national cross‐sectional study in women

“…The increased risk of urinary dysfunction in RC patients has been reported in an earlier study with a small number of patients, which found that significantly more patients had urinary dysfunction after rectal resection than after segmental colectomy [19]. A few previous studies have been conducted in cohorts with more than 100 female patients with RC; all reported a correlation between treatment for RC and subsequent urinary dysfunction [5,7–10].…”

Electrolyte depletion syndrome (McKittrick–Wheelock syndrome) successfully treated by endoscopic submucosal dissection

“…Partial colectomy performed surgically is the current standard treatment for McKittrick-Wheelock syndrome (MWS) [2,3]. However, its invasiveness and postoperative complications are sometimes problematic [4,5]. Moreover, if colostomy is required, the patient's quality of life is drastically reduced.…”