Sexual dysfunction after curative radical resection of rectal cancer in men: The role of extended systematic lymph node dissection
Cavit Cöl, Oguz Hasdemir, Erol Yalçin, Kemal Yandakçi, Gunduz Tunç, Tevfik Kuçukpinar
Med Sci Monit 2006; 12(2): CR70-74
Background: This study was designed to determine the incidence and patternsof sexual dysfunction after curative radical resections (CRR) with or without extended systematic lymph-nodedissection (ESLND) for rectal cancer Material/Methods: A total of 91 patients with rectal cancer werereviewed with respect to surgical procedures and postoperative sexual functions using the InternationalIndex of Erectile Function (IIEF), a 15-item self-administered questionnaire. CCR (abdomino-perinealresections or sphincter-saving anterior resections) was performed in 78 patients (Group I) and ESLNDplus CRR in 13 patients (Group II), and sexual functions were also evaluated in the colostomy and non-colostomysubgroups. Results: In the postoperative period, the five domains of IIEF scoring decreased significantlyfrom the preoperative scores in both groups (p0.05). Having a permanent colostomy decreases IIEF scores in all colostomizedpatients. Conclusions: CRR and CRR+ESLND both decrease sexual function and lymph-node dissection is notconsidered to have any additive effect on this decrease. In addition to standard surgery, anxiety abouthaving a malignant disease and permanent colostomy may play an important role in male sexual dysfunction.
Keywords: Aged, Adult, Colostomy - adverse effects, Humans, Lymph Node Excision - adverse effects, Male, Middle Aged, Postoperative Complications - psychology, Questionnaires, Rectal Neoplasms - surgery, Sexual Dysfunction, Physiological - psychology, Sexual Dysfunctions, Psychological - etiology