Sexual and urological problems after surgery for rectal cancer are common, multifactorial, inadequately discussed, and untreated.
The urogenital function is dependent on dual autonomic sympathetic and parasympathetic innervation, and four key danger zones exist that are at risk for nerve damage during colorectal surgery.
One of these sites is in the abdomen and three are in the pelvis.
Dr Celentano and colleagues systematically reviewed the epidemiology of sexual dysfunction following rectal cancer surgery, to describe the anatomical basis of autonomic nerve-preserving techniques, and explored the scientific evidence available to support the laparoscopic or robotic approach over open surgery.
|There is no evidence to date in favor of any surgical approach|
|International Journal of Colorectal Disease|
According to the PRISMA guidelines, a comprehensive literature search of studies evaluating sexual function in patients undergoing rectal surgery for cancer was performed in Medline, Scopus, Web of Science, Embase, and Cochrane Central Register of controlled trials.
The researchers found that an increasing number of studies assessing the incidence and prevalence of sexual dysfunction following multimodality treatment for rectal cancer has been published over the last 30 years.
Dr Celentano's team comments, "There is no evidence to date in favor of any surgical approach."
"Standardized diagnostic tools should be routinely used to prospectively assess sexual function in patients undergoing rectal surgery."