Sexual Impairment and Its Effects on Quality of Life in Patients With Rectal Cancer

Schmidt, Christian; Daun, Anna; Malchow, Björn; Küchler, Thomas

doi:10.3238/arztebl.2010.0123

Cited by 26 publications

(24 citation statements)

References 22 publications

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“…34 in addition, an increased risk of surgical damage to the pelvic autonomic nerves contributes to the morbidity associated with this technique, as avulsion of the pelvic splanchnic nerves from their sacral roots is likely to occur following an inadvertent tear of the presacral parietal fascia during the perineal phase of the procedure. 13,43,54,55 Pelvic lymph node dissection the addition of extended pelvic lymph node dissection to simple tumor resection adversely influences urinary and sexual function. in western countries this procedure is sometimes added to surgical resection in patients with metastatic disease.…”

Section: Ihpmentioning

confidence: 99%

Urinary and sexual dysfunction after rectal cancer treatment

2010

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In light of the improving prognosis for patients with rectal cancer, the quality of functional outcome has become increasingly important. Despite the good functional results achieved by expert surgeons, large multicenter studies show that urogenital dysfunction remains a common problem after rectal cancer treatment. More than half of patients experience a deterioration in sexual function, consisting of ejaculatory problems and impotence in men and vaginal dryness and dyspareunia in women. Urinary dysfunction occurs in one-third of patients treated for rectal cancer. Surgical nerve damage is the main cause of urinary dysfunction. Radiotherapy seems to have a role in the development of sexual dysfunction, without affecting urinary function. Pelvic autonomic nerves are especially at risk in cases of low rectal cancer and during abdominoperineal resection. Data concerning nerve damage during laparoscopic surgery for resection of rectal cancer are awaited. Structured education of surgeons with regard to pelvic neuroanatomy, and systematic registration of identified nerves, could well be the key to improving functional outcome for these patients. Meanwhile, patients should be informed of all associated risks before their operation, and their functional status should be evaluated before and after surgery.

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Section: Ihpmentioning

confidence: 99%

Urinary and sexual dysfunction after rectal cancer treatment

2010

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“…[4, 11] Those who remain active, however, report high rates of symptoms associated with vulvovaginal atrophy, such as dryness and pain with sex (dyspareunia), as well as problems like vaginal stenosis, loss of sexual desire, and interference with sex from fecal incontinence. [4-6, 20] Rates of female sexual problems, especially dyspareunia, are higher after APR than other types of anterior resection (AR),[6, 25, 26] and are also increased in women who have adjuvant radiotherapy. [6, 9, 10, 19]…”

Section: Introductionmentioning

confidence: 99%

The association between psychosocial and medical factors with long-term sexual dysfunction after treatment for colorectal cancer

Milbury

Cohen

Jenkins

et al. 2012

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Purpose Colorectal cancer patients usually receive treatments (e.g., pelvic surgery or radiotherapy, colostomy) that increase their risk for sexual problems. Previous research has mainly focused on demographic and medical risk factors. Because little is known about the role of psychosocial variables in sexual dysfunction, this research sought to identify the contribution of demographic, medical and psychosocial factors to sexual dysfunction using multivariate analyses. Methods Male and female colorectal cancer survivors (N=261, mean: 2.5 years post-treatment) completed paper-pencil questionnaires assessing sexual function, psychosocial variables (e.g., depression, social support, body image, dyadic adjustment) and demographics. Medical information was obtained from patients’ self-report and medical records. Results Multiple regression analyses revealed that older age, having received destructive surgery (i.e., abdominoperineal resection), and poor social support were uniquely and significantly associated with low International Index of Erectile Function scores in men. For women, low Female Sexual Function Index scores were significantly associated with older age and poor global quality of life. Men, but not women, with rectal cancer reported worse sexual function compared to those with colon cancer. Conclusions Sexual dysfunction after colorectal cancer treatment is related to demographic, medical, and psychosocial factors. These associations can help to identify patients at high risk of sexual problems in order to assist restoring sexual functioning if desired.

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“…There are a number of studies investigating HRQoL and sexual function comparing abdominoperinal extirpation and low anterior resection without permanent colostomy. Some studies report a comparable HRQoL in both operations [5,6] while other studies have found a better HRQoL or sexual function in sphincter preserving operations [7][8][9]. Interestingly, in these latter studies, sphincter preservation or improved anorectal function did not necessarily translate into an improved quality of life [5,6], and a meta-analysis by Pachler et al failed to demonstrate the superiority of sphincter preservation on HRQoL after rectal resection [10].…”

Section: Introductionmentioning

confidence: 89%

Objective measurable anoneorectal function poorly correlates with the overall quality of life after mesorectal excision for rectal cancer

et al. 2012

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Background: Health related quality of life and functional disturbances of the neorectum are increasingly gaining in importance.Methods: 48 patients after mesorectal excision were examined in a retrospective cohort study by anorectal manometry and pelvic floor surface electromyography. HRQoL was assessed by the SF-36 and the EORTC QLQ 30 questionnaire. Sexual and urogenital functions were examined by the IIEF and IPSS questionnaire.Results: Mean resting-/squeeze-pressure was almost normal at 59.8 ± 18.9 mm Hg/132.1 ± 16.2 mm Hg. Perception-and defecation level were at 49.4 ± 21 ml and at 100.9 ± 44.3 ml. Average and maximal amplitude of the pelvic floor EMG was 9.5 ± 2 mV and 14.2 ± 2.6 mV. Mild positive correlation was given between minimal resting pressure and nausea/social function r ¼ 0.495/r ¼ 0.344. Maximal amplitude significantly correlated with physical function (r ¼ 0.386). The SF-36 data were compared to the standardized control sample of n ¼ 2914 German subjects. For both IIEF (23.8 ± 20.7) and IPSS (irritative: 3.6 ± 3.3/obstruction 2.8 ± 4.2), we found markedly reduced function scores but high inter-individual variations.Conclusions: The link between measurable anorectal function and HRQoL is poor after mesorectal excision. Anoneorectal function after one year is not an exclusive factor having an impact on HRQoL.

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Sexual Impairment and Its Effects on Quality of Life in Patients With Rectal Cancer

Abstract: These findings show that the quality of life is changed by surgery for rectal cancer and is influenced by the patient's sex and age, as well as by the particular surgical approach used.

Cited by 26 publications

References 22 publications

Urinary and sexual dysfunction after rectal cancer treatment

Urinary and sexual dysfunction after rectal cancer treatment

The association between psychosocial and medical factors with long-term sexual dysfunction after treatment for colorectal cancer

Objective measurable anoneorectal function poorly correlates with the overall quality of life after mesorectal excision for rectal cancer

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