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Complications and Sexual Function After Vaginectomy for Anorectal Tumors

  • Published:
Diseases of the Colon & Rectum

Purpose

The objective of this study was to determine complication rates and functional outcomes of females who underwent vaginectomy during anorectal tumor resection and to determine whether flap reconstruction of the vagina improves sexual function.

Methods

A retrospective review was performed of all females who underwent multivisceral resections involving the vagina for anorectal tumors at two academic hospitals from 1985 to 2004. Living patients were contacted, and a 25-question telephone questionnaire was administered.

Results

Fifty-four patients were identified. Nineteen patients had flap reconstruction of the vagina and 35 had primary repair. Eighty-three percent of patients experienced surgical complications, including perineal wound complications in 33 percent (14/42) of those with perineal incisions and vaginal complications in 41 percent (22/54) of the cohort. There was a nonsignificant decrease in perineal wound complications when flap reconstruction was performed (22 vs. 42 percent). Twenty-three patients completed the questionnaire (96 percent of those eligible). Six patients were able to have sexual intercourse after surgery and nine were not. Reasons for inability to have sexual intercourse were: inadequate vaginal capacity (n = 4), pain (n = 2), and chronic wound or fistula (n = 3). No living patients who had flap reconstruction were able to have sexual intercourse. Only 20 percent of patients remembered a preoperative discussion of possible sexual effects of surgery; however, overall quality of life was preserved.

Conclusions

Anorectal tumor resections involving the vagina are associated with a high rate of complications, including inability to have intercourse after surgery, even with flap reconstruction. Females should be counseled regarding potential loss of sexual function.

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Authors and Affiliations

  1. Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada

    Samantha K. Hendren M.D., Carol J. Swallow M.D., Ph.D., Joan E. Lipa M.D., M.Sc., Zane Cohen M.D., Helen M. MacRae M.D., Robert Gryfe M.D., Ph.D., Brenda I. O’Connor B.S.C.N. & Robin S. McLeod M.D.

  2. Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada

    Carol J. Swallow M.D., Ph.D., Robert Gryfe M.D., Ph.D. & Robin S. McLeod M.D.

  3. Department of Surgery, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada

    Andrew Smith M.D.

  4. Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Samantha K. Hendren M.D., Carol J. Swallow M.D., Ph.D., Andrew Smith M.D., Joan E. Lipa M.D., M.Sc., Zane Cohen M.D., Helen M. MacRae M.D., Robert Gryfe M.D., Ph.D. & Robin S. McLeod M.D.

  5. Division of Plastic and Reconstructive Surgery, University of Toronto, Toronto, Ontario, Canada

    Joan E. Lipa M.D., M.Sc.

  6. Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

    Robin S. McLeod M.D.

  7. Mount Sinai Hospital, 600 University Avenue, Room 449, Toronto, Ontario, M5G1X5, Canada

    Robin S. McLeod M.D.

Authors
  1. Samantha K. Hendren M.D.
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  2. Carol J. Swallow M.D., Ph.D.
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  3. Andrew Smith M.D.
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  4. Joan E. Lipa M.D., M.Sc.
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  5. Zane Cohen M.D.
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  6. Helen M. MacRae M.D.
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  7. Robert Gryfe M.D., Ph.D.
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  8. Brenda I. O’Connor B.S.C.N.
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  9. Robin S. McLeod M.D.
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Corresponding author

Correspondence to Robin S. McLeod M.D..

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Hendren, S.K., Swallow, C.J., Smith, A. et al. Complications and Sexual Function After Vaginectomy for Anorectal Tumors. Dis Colon Rectum 50, 810–816 (2007). https://doi.org/10.1007/s10350-006-0867-9

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  • DOI: https://doi.org/10.1007/s10350-006-0867-9

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