Comparative study of voiding and male sexual function following open and laparoscopic total mesorectal excision in patients with rectal cancer

Hyuk Hur, Sung Uk Bae, Nam Kyu Kim, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Young Tae Kim, Young Deuk Choi
Journal of Surgical Oncology 2013, 108 (8): 572-8

BACKGROUND: This study aimed to compare voiding and male sexual dysfunction between open and laparoscopic rectal cancer surgery.

METHODS: Ninety-seven patients (62 male and 35 female) who underwent open (n = 41) or laparoscopic (n = 56) surgery for rectal cancer were prospectively enrolled. Urine flowmetry, the international prostate symptom score, and the international index of erectile function were assessed preoperatively and postoperatively.

RESULTS: Voiding function score increased 1 month after surgery (open: 9.3 ± 4.6 to 14.0 ± 8.2, laparoscopic: 8.3 ± 5.3 to 12.3 ± 5.2; P = 0.002 and P < 0.001). The score was even higher in both groups after 6 months, but the increases were not statistically significant (open: 9.9 ± 4.5, laparoscopic: 9.2 ± 5.6; P = 0.546 and P = 0.280). Male patients who underwent open surgery (n = 22) experienced declining sexual function until 12 months post surgery (before: 55.2 ± 9.8, 12 months: 48.7 ± 15.9, P = 0.031). In laparoscopic group (n = 28), sexual function decreased until 6 months after surgery, but rose again by 12 months (before: 55.4 ± 9.0, 12 months: 52.2 ± 11.7, P = 0.134).

CONCLUSIONS: Voiding dysfunction recovered after 6 months following both open and laparoscopic surgery. Male sexual function recovered more quickly in laparoscopic group and returned to preoperative levels after 12 months.

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