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Urinary and Sexual Disorders After Laparoscopic TME for Rectal Cancer in Males

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Urinary and sexual dysfunctions are frequent after surgery for rectal cancer. Total mesorectal excision (TME) improves local recurrence and survival rates, and does not hamper recognition and sparing of hypogastric and pelvic splanchnic nerves. It is not known how laparoscopic rectal resection could change functional complication rates.

Materials and Methods

From a global series of 1,216 laparoscopic interventions for colorectal diseases, 35 cases of males less than 70 years old, undergoing rectal resection and TME for a T1-3M0 medium and low rectal cancer were selected. Urinary and sexual functions after the operations were retrospectively recorded by means of specific tools (International Prostate Symptom Score (IPSS) and IIEF questionnaires, respectively).

Results

None of the patients necessitated permanent or intermittent catheterization. More than half the patients had no complaints about urinary functions; about one third had nocturia; 72% of the patients had an IPSS less that 10, and no case of IPSS worse that 31 was recorded. Sexual desire was reduced and spontaneous erectile function was impaired in almost half the cases, while induced erections were possible in about 90% of cases; about 70% of patients still had the possibility of penetration and a normal ejaculation and orgasm after the intervention.

Discussion and Conclusions

The present series confirms previous data and contribute to the creation of a benchmark specifically related to the laparoscopic approach to which surgeons should face when informing the patients before the operation. While severe urinary dysfunction is rare, sexual impairment remains a serious concern after rectal resection with TME.

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Authors and Affiliations

  1. U.O. Chirurgia Generale, Ospedale di Castelfranco Veneto, Treviso, Italy

    Carlo Augusto Sartori, Alberto Sartori, Silvia Vigna, Rosario Occhipinti & Gian Luca Baiocchi

  2. Surgical Clinic, Brescia University, Brescia, Italy

    Gian Luca Baiocchi

Authors
  1. Carlo Augusto Sartori
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  2. Alberto Sartori
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  3. Silvia Vigna
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  4. Rosario Occhipinti
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  5. Gian Luca Baiocchi
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Correspondence to Gian Luca Baiocchi.

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Sartori, C.A., Sartori, A., Vigna, S. et al. Urinary and Sexual Disorders After Laparoscopic TME for Rectal Cancer in Males. J Gastrointest Surg 15, 637–643 (2011). https://doi.org/10.1007/s11605-011-1459-0

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  • DOI: https://doi.org/10.1007/s11605-011-1459-0

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