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Urogenital function 3 years after abdominoperineal excision for rectal cancer

Journal article
Authors A. Ledebo
David Bock
Mattias Prytz
Eva Haglind
Eva Angenete
Published in Colorectal Disease
Volume 20
Issue 6
Pages O123-O134
ISSN 1462-8910
Publication year 2018
Published at Institute of Clinical Sciences, Department of Surgery
Pages O123-O134
Language en
Links dx.doi.org/10.1111/codi.14229
Keywords Rectal cancer, prostate cancer, urinary dysfunction, sexual dysfunction, urogenital dysfunction, quality-of-life, poisson regression approach, sexual dysfunction, radical prostatectomy, preoperative radiotherapy, randomized-trial, urinary, surgery, resection, women, Gastroenterology & Hepatology, Surgery
Subject categories Gastroenterology and Hepatology

Abstract

Aim 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 3 years after abdominoperineal excision, and to compare outcomes with a reference population and a cohort of patients operated for prostate cancer. Method Patients treated with abdominoperineal excision in 2007-2009 were identified using the Swedish Colorectal Cancer Registry. All consenting patients received a questionnaire. A sample of the Swedish population was contacted and completed a questionnaire. Patients undergoing radical prostatectomy in a prospective multicentre trial received questionnaires 24 months after surgery. Results In the abdominoperineal excision, reference and radical prostatectomy populations 72%, 51% and 91% of the questionnaires were returned. Within the abdominoperineal excision group 36% of the men and 57% of the women were incontinent postoperatively. Fifteen per cent and 37% of men and women in the reference group were incontinent. Two years after radical prostatectomy 49% were incontinent. Seventy-four per cent of the men had erectile dysfunction after abdominoperineal excision. Nineteen per cent 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. Conclusion 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.

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