gms | German Medical Science

Aim: Erectile dysfuntions are frequent complications of visceral surgery in the form of rectal resection for rectal carcinoma. Yet, they are rarely described in literature. Thus, our study aims at evaluating incidence and form of erectile dysfunction within our patient collective.

Material and methods: From 2000-2004, 536 patient were surgically treated for rectal carcinoma in the University Hospital Erlangen. Patients with tumor recrudescence and patients who have since died were not considered in this study. All male patients were asked in retrospect about their sexual functions before and after surgery, using standardized questionnaires (International Index of Erectile Function, IIEF). 128 questionnaires could be evaluated statistically, using the SPSS (Statistical Product and Service Solutions) computer program. Univariate analysis involved Chi squared test as well as Mann-Whitney-U test.

Results: 11 patients were not sexually active before surgery. After surgery, this number increased to 63. Preoperatively, 12 patients did not reach full rigidity of the penis; postoperatively there were 68 patients. Penetration was not possible for 17 patients preoperatively, and 69 postoperatively. 2 patients couldn’t ejaculate before surgery; after surgery 18 patients replied the same. 6 patients could not reach an orgasm before surgery, after surgery the number climbed to 24. Preoperatively, 5 patients experienced a lack of libido; so did 32 patients postoperatively. Before surgery, 2 patients were not satisfied with their sexual life; after surgery 30 patients felt equally discontent.

Conclusion: Erectile Dysfunctions are common complications after rectal resection for carcinoma. Possible explanations for the high incidence are the radicality of surgery, or (follow-up) radiation. These patients need urological support to treat their erectile dysfunctions.