Sexuální dysfunkce po sfinkter-záchovných resekcích konečníku

Abstract

Increase in number of sphincter-preserving rectal resections for carcinoma, as well as improved patient survival brings to the fore the question relating to quality of patient's life also in the sense of influencing their sexual functions. These functions may be reduced (temporary or permanently) as a consequence of surgery, radiotherapy or mental suffering of patients with malignant disease. Using standardized questionnaires, in this prospective study of 42 patients with rectal cancer, pre-operative and post-operative sexual functions of men (International Index of Erectile Function; IIEF) and women (modified Female Sexual Function Index; FSFI) were compared. Impact of the conventional (open) versus laparoscopic surgical approach on the deterioration of sexual functions, as well as risk factors in relation to the tumour, and risk demographic characteristics of patients were assessed. In total, 28 of 42 patients (67.7%) were sexually active preoperatively. In the group of 20 men, a worsening of sexual functions occurred in 15 patients (75.0%). This deterioration of sexual functions in men was statistically significant (P = 0.01). In the group of 8 women, a worsening occurred in 4 patients (50.0%), but it was not statistically significant. As risk factor the perioperative blood loss in women was identified (P = 0.1). The influences of the age, BMI, tumour size and distance, and duration of surgery were not found out. Impact of the open or laparoscopic approach on sexual dysfunctions was not proven.