Rectal cancer surgery for male individuals' sexual and urinary function

Jianmiao HE; Yongdong PU

ABSTRACT

BACKGROUND:

The occurrence of sexual and urinary dysfunction is higher in patients who have received rectal cancer surgeries. This could most likely be correlated with the age of the patients and the approach applied in the operation. Therefore, how to preserve the sexual and urinary functions has become a hot point in this field.

OBJECTIVE:

This study was designed to investigate the influence of differences in age and therapeutical approach on the sexual and urinary function in patients with rectal cancer.

DESIGN:

Investigation study on patients.

SETTING:

General Surgery Department, the 309 Clinical Division, General Hospital of Chinese PLA.

PARTICIPANTS:

Some male patients with rectal cancer hospitalized in the General Surgery Department, the 309 Clinical Division, General Hospital of Chinese PLA were involved from January 1999 to October 2000. All of the 79eligible patients had received a radical surgery for rectal cancer by the time of study. Their sexual and urinary function before surgery were normal and an over-2-year follow-up after surgery was conducted on each of them. The two groups, which were classified into two groups according to surgical ap-proaches they received, contained comparable quantity of sampling and age distributions, which prompts the validity of the comparison.

METHODS:

By distributing follow-up letters, outpatient inquiries and phone call investigations; the follow-up was conducted to evaluate the sexual functions in these patients, including their penile erection and ejaculation. The erectile function was assessed according to the International Index of Erectile Function Questionnaire-5 (IIEF-5). The assessment on ejaculation was based on whether the patients had a sexual climax and whether they can ejaculate. The definition of urinary function consisted of both short-term and long-term urinary functions.MAIN OUTCOME

MEASURES:

The sexual desire, erectile function, ejaculation and the urinary function in patients within different age brackets.

RESULTS:

After Miles operation, 81% patients developed sexual dysfunction, 46% got short-term urinary dysfunction(19/41) and 5 % (2/41) had long-term urinary dysfunction. While after Dixon operation, 55% patients had sexual dysfunction, 29% (11/38) had short-term urinary dysfunction, and none of the patients had long-term urinary dysfunction. The difference between the outcomes of the two operations was significant( P ＜ 0. 05) .Sexual dysfunction occurred at a rate of 38% in the less-than-40 age bracket, 60% in the 40-to-59 age bracket, and 96% in the over-60 age bracket. The overall differences between different pairs of age brackets were significantly ( P ＜ 0. 05 ).

CONCLUSION:

There is a high rate of postoperative sexual and urinary dysfunction in male population. The age of patients and the approach adopted in the surgery are directly correlated with the rate of dysfunction. An autonomic nerve-preserving radical operation for rectal cancer can reduce the occurrence of sexual and urinary dysfunction effectively.