Sexual function may be harmed after treatment for rectal cancer. This
study aimed to evaluate prospectively the incidence of sexual
dysfunction after rectal cancer treatment and to compare the effects of
laparoscopic and traditional open approaches in terms of postoperative
sexual function.
Baseline and 3-, 6-, and 12-month assessments of sexual dysfunction
using the International Index of Erectile Function (IIEF) and its
specific domains prospectively took place for 56 patients who underwent
rectal cancer surgery (38 open vs. 18 laparoscopic procedures, 38 low
anterior vs. 18 abdominoperineal resections). The preliminary results
are presented.
The average total IIEF and isolated IIEF response domain scores were
significantly decreased after surgery (p < 0.01) except for the
intercourse satisfaction and overall satisfaction scores at 12 months.
An improvement in IIEF scores was observed between the 3- and 6-month
assessment points (p < 0.01) except for the erectile function and
orgasmic function scores. No significant differences were observed
between the open and laparoscopic groups in the total IIEF and domain
scores preoperatively and at the 3- and 6-month assessment points. The
rates of sexual dysfunction did not differ significantly preoperatively
or at 3 months postoperatively when open and laparoscopic procedures
were compared, although there was a trend in favor of laparoscopic
surgery at 6 months (p = 0.076). The baseline IIEF score and the
baseline, 3-, and 6-month sexual desire scores were better (p = 0.035,
0.004, 0.017, and 0.061, respectively) in the low anterior resection
group than in the abdominoperineal resection group.
Rectal cancer resections were postoperatively associated with a
significant reduction in IIEF scores and high rates of sexual
dysfunction at 3 and 6 months. The IIEF and domain scores at different
assessment points were comparable between the laparoscopic and open
surgery groups. Extending the monitoring period and adding more patients
in this ongoing prospective study will further elucidate postoperative
sexual dysfunction after rectal cancer surgery