International Journal of Colorectal Disease

, Volume 32, Issue 11, pp 1523–1530 | Cite as

Sexual dysfunction following rectal cancer surgery

  • V CelentanoEmail author
  • R Cohen
  • J Warusavitarne
  • O Faiz
  • M Chand



Sexual and urological problems after surgery for rectal cancer are common, multifactorial, inadequately discussed, and untreated. The urogenital function is dependent on dual autonomic sympathetic and parasympathetic innervation, and four key danger zones exist that are at risk for nerve damage during colorectal surgery: one of these sites is in the abdomen and three are in the pelvis. The aim of this study is to systematically review the epidemiology of sexual dysfunction following rectal cancer surgery, to describe the anatomical basis of autonomic nerve-preserving techniques, and to explore the scientific evidence available to support the laparoscopic or robotic approach over open surgery.


According to the PRISMA guidelines, a comprehensive literature search of studies evaluating sexual function in patients undergoing rectal surgery for cancer was performed in Medline, Scopus, Web of Science, Embase, and Cochrane Central Register of controlled trials.


An increasing number of studies assessing the incidence and prevalence of sexual dysfunction following multimodality treatment for rectal cancer has been published over the last 30 years. Significant heterogeneity in the prevalence of sexual dysfunction is reported in the literature, with rates between 5 and 90%.


There is no evidence to date in favor of any surgical approach (open vs laparoscopic vs robotic). Standardized diagnostic tools should be routinely used to prospectively assess sexual function in patients undergoing rectal surgery.


Sexual dysfunction Rectal cancer Colorectal surgery Nerve sparing surgery Erectile dysfunction 


Compliance with ethical standards

Conflict of interest statement

The authors declare that there is no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • V Celentano
    • 1
    Email author
  • R Cohen
    • 2
  • J Warusavitarne
    • 3
  • O Faiz
    • 3
  • M Chand
    • 2
  1. 1.Department of Colorectal Surgery, Queen Alexandra HospitalPortsmouth Hospitals NHS TrustPortsmouthUK
  2. 2.Department of Colorectal SurgeryUniversity College London HospitalsLondonUK
  3. 3.Department of SurgerySt. Mark’s HospitalHarrowUK

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