Document Detail

Total mesorectal excision preserves male genital function compared with conventional rectal cancer surgery.
MedLine Citation:
PMID:  11683749     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The introduction of total mesorectal excision (TME) has been shown to improve local recurrence rates in rectal cancer. The present study investigated the impact of this more extensive and radical procedure with regard to autonomic pelvic nerve function. METHODS: Patients with resected primary rectal cancer were interviewed by means of a questionnaire asking about preoperative and postoperative urinary bladder and genital function. The results in patients after rectal cancer surgery without TME (group 1; n = 29) were compared with those obtained after introduction of the TME technique (group 2; n = 31). Patients in group 2 were older and had a lower level of anastomosis than patients in group 1. Other patient, treatment and tumour characteristics were comparable between the groups. RESULTS: : Newly acquired and permanent symptoms of bladder dysfunction after rectal excision were present as follows (group 1 versus group 2): difficulty in bladder emptying 7 versus 19 per cent; sensation of incomplete bladder voiding 17 versus 17 per cent; urgency 17 versus 14 per cent; incontinence 10 versus 3 per cent; dysuria 7 versus 7 per cent; and dribbling 14 versus 8 per cent. Male patients stated the following sexual functions before operation/after operation in group 1 versus group 2: interest in sex 80 per cent/40 per cent versus 63 per cent/37 per cent; sexually active 67 per cent/7 per cent versus 53 per cent/22 per cent; impotence 75 per cent/6 per cent versus 58 per cent/26 per cent; ability to have intercourse 75 per cent/13 per cent versus 67 per cent/29 per cent; ability to achieve orgasm 88 per cent/13 per cent versus 76 per cent/47 per cent; and orgasm with ejaculation 88 per cent/9 per cent versus 76 per cent/53 per cent. CONCLUSION: While both conventional rectal cancer surgery and TME result in similarly favourable postoperative bladder function, both techniques decrease sexual function. However, TME offers a significant advantage with regard to preservation of postoperative sexual function in men and constitutes a true advance in rectal cancer surgery compared with conventional techniques.
C A Maurer; K Z'Graggen; P Renzulli; M K Schilling; P Netzer; M W Büchler
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  88     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-10-30     Completed Date:  2001-12-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  1501-5     Citation Subset:  AIM; IM    
Department of Visceral and Transplantation Surgery and Gastroenterology, Inselspital, University of Bern, CH-3010 Bern, Switzerland.
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MeSH Terms
Aged, 80 and over
Colorectal Surgery / methods
Middle Aged
Neoplasm Recurrence, Local
Postoperative Complications / prevention & control*
Rectal Neoplasms / surgery*
Sexual Dysfunction, Physiological / prevention & control*
Urinary Bladder Diseases / physiopathology,  prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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