Sexual dysfunctions following low anterior resection of the rectum in rectal cancer patients

Abstract

Introduction. Low anterior resection of the rectum (LAR) is a treatment of choice in patients with diagnosed low rectal cancer. Rectal cancer surgery has a close relationship with the urinary-sexual organs and also with related nerves and nerve plexus. Thus, the sympathetic and parasympathetic nerves of the pelvic area may be damaged. As a result of this, the important point is the sexual function loss following rectal surgeries. The aim of the study was to investigate the sexual disorders in patients with rectal cancer who underwent LAR. Materials and methods. In this retrospective study the sexual activity, comfort of the experience, quality of sexual life (QoSL) during 3 periods were analyzed: before surgery, a month after and half a year after surgery. Analysis of demographic characteristics, comorbidities, previous surgeries, toumor characteristics and adjuvant therapy as was performed. Results. Most patients (64/100, 64%) expressed that LAR operation has strongly affected their QoSL, 32 patients reported the mild decrease in QoSL, while only 4 patients stated that did not experience any changes in QoSL. QoSL was assessed in 3 different periods of time: before the operation, 1 month after and 6 months after the operation (22,6±3.7 vs. 11.3±7,9 vs. 17,0±6.3; p<0.0001 respectively). The decreased QoSL one and six months after the surgery were significantly lower in patients with diagnosed hypertension and higher BMI (p=0.0283). Conclusions. Sexual disorders after LAR for rectal cancer are often underestimated and it is very important to be aware of them. In our study, it was determined that male sex, higher BMI and hypertension are related to impair of sexual dysfunction after LAR. We observed that the most severe complaints related to sexual activity occur one month after the procedure, after 6 months in most of the patients' sexual disorders were decreased approaching the initial state.

Excessive bowel volume loss during anus-preserving surgery for rectal cancer affects the bowel function after operation: A prospective observational cohort study (Bas-1611)

“…Normally distributed variables were analysed using t -test and ANOVA, whereas non-normally distributed variables were analysed using the Mann–Whitney U test and Kruskal–Wallis test. The key indicators obtained using univariate analysis and other recognised risk factors related to LARS (such as radiotherapy, tumour location, body mass index [BMI] and stoma [ 2 , [21] , [22] , [23] , [24] , [25] , [26] ]) were subjected to generalised estimating equation. A p-value of <0.05 was considered statistically significant.…”

Management of treatment‐related sequelae following colorectal cancer

“…Studies have found that bowel dysfunction is associated with a lack of sexual desire, sexual inactivity and sexual dissatisfaction. Specifically, faecal incontinence has a significant impact on sexuality (desire, frequency of intercourse, reaching orgasm and satisfaction with hugging and kissing) [110,141,145] (2b). In a case-control study, CRC survivors with ostomy were more anxious than healthy volunteers, and a low frequency of sexual intercourse was significantly more common in this patient group (68% vs. 30%), with 54% avoiding intercourse compared with 4% among controls [146] (3b).…”

“…ED or impotence is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance and is reported in 11%-93% of CRC survivors [143][144][145][147][148][149][150] (2b), whereas EJD is reported in 19%-68% [144,145,148] (2b).…”