Urogenital function three years after abdominoperineal excision for rectal cancer

The aim of this study was to explore urogenital dysfunction and associated risk factors after treatment of rectal cancer, in a large national cohort of patients three years after abdominoperineal excision and to compare outcomes with a reference population and a cohort of patients operated for prostate cancer.

Patients treated with abdominoperineal excision 2007-2009 were identified using the Swedish ColoRectal Cancer Registry. All consenting patients received a questionnaire. A sample of a Swedish population was contacted and completed a questionnaire. Patients undergoing radical prostatectomy in a prospective multicenter trial received questionnaires 24 months after surgery.

72, 51 and 91% of the questionnaires were returned in the abdominoperineal excision, reference and radical prostatectomy populations. Within the abdominoperineal excision group 36% of the men and 57% of the women were incontinent postoperatively. 15% and 37% of men and women in the reference group were incontinent. Two years after radical prostatectomy 49% were incontinent. Seventy-four % of the men had erectile dysfunction after abdominoperineal excision. 19% of the women experienced reduced ability to reach orgasm. Fewer men and women experienced their present sex life as satisfying after abdominoperineal excision for rectal cancer compared with the reference population.

A large proportion of patients endure persistent urogenital dysfunction after abdominoperineal excision for rectal cancer as do men after radical prostatectomy. Effects on sexual and urinary function should be part of preoperative information and after surgery patients should be asked about function in order to identify those in need of further assistance. This article is protected by copyright. All rights reserved.

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 2018 Apr 21 [Epub ahead of print]

Anna Ledebo, David Bock, Mattias Prytz, Eva Haglind, Eva Angenete

Department of Surgery, NU Hospital group, Trollhättan, Sweden., Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, SSORG - Scandinavian Surgical Outcomes Research Group, Sahlgrenska University Hospital/Östra, 416 85, Gothenburg, Sweden.