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Published in: International Journal of Colorectal Disease 12/2010

01-12-2010 | Original Article

Prospective study of sexual dysfunction in men with rectal cancer: feasibility and results of nerve sparing surgery

Authors: Valerio Celentano, Giovanni Fabbrocile, Gaetano Luglio, Giovanni Antonelli, Rachele Tarquini, Luigi Bucci

Published in: International Journal of Colorectal Disease | Issue 12/2010

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Abstract

Purpose

Rectal cancer surgery is impaired by a high rate of postoperative sexual dysfunction cause of frequent nerve injuries. The aim of this study was to prospectively evaluate sexual function in a group of male patients after total mesorectal excision (TME) for rectal cancer, using an autonomic nerve sparing technique.

Methods

All patients underwent autonomic nerve preserving TME. Sexual function was assessed using the International Index of Erectile Function standardized questionnaire. All patients were studied preoperatively and at 3, 6, 12, 18, and 24 months after surgery.

Results

Fifty-one patients with adenocarcinoma of the rectum were enrolled; after excluding 16 patients not sexually active, nine with T4 stage disease and six with metastatic disease, 20 patients were prospectively evaluated. The preoperative erectile function (EF) domain score of the International Index of Erectile Function was 24.3 (±4.1). The score of the EF domain was 17.6 (±7.5), 19.l9 (±7.2), 20.3 (±7.4), 20.5 (±7.4), and 20.6 (±7.4) at 3, 6, 12, 18, and 24 months after surgery. In the group of patients in which there were no macroscopic damages to the nerves, only two out of 15 (13.3%) developed erectile dysfunction. All five patients in whom incomplete pelvic nerve preservation was necessary developed erectile dysfunction.

Conclusion

Our data show that nerve sparing technique can reduce the incidence of sexual dysfunction. Unfortunately, the technique is not applicable in every patient. Indications and techniques of autonomic nerve preservation are not standardized. Controlled trials with long-term follow-up seem to be necessary.
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Metadata
Title
Prospective study of sexual dysfunction in men with rectal cancer: feasibility and results of nerve sparing surgery
Authors
Valerio Celentano
Giovanni Fabbrocile
Gaetano Luglio
Giovanni Antonelli
Rachele Tarquini
Luigi Bucci
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 12/2010
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-010-0995-5

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