Dr Samantha Hendren and colleagues measured sexual function and quality of life after rectal cancer treatment.
The researchers noted that previous studies on sexual function after rectal cancer treatment have focused on males and have not used validated instruments.
Patients undergoing curative rectal cancer surgery from 1980 to 2003 were administered a questionnaire.
The team included the Female Sexual Function Index or International Index of Erectile Function, and the EORTC quality of life questionnaire-C30/CR-38.
Multiple logistic regression was used by the team to test associations of clinical factors with outcomes.
The researchers reported that 81% of women and 80% of men returned the questionnaire.
The team found that 32% of women and 50% of men were sexually active after surgery, compared with 61% and 91% preoperatively.
The team also found that 29% of women and 45% of men reported that "surgery made their sexual lives worse.”
|Radiation therapy was associated with the outcome "surgery made sexual life worse”|
|Annals of Surgery|
The mean Female Sexual Function Index and International Index of Erectile Function scores were 18 and 29, respectively.
The team noted that specific sexual problems in women were libido in 41%, arousal in 29%, lubrication in 56%, orgasm in 35%, and dyspareunia in 46%.
Specific sexual problems in men were libido in 47%, impotence in 32%, partial impotence in 52%, orgasm in 41%, and ejaculation in 43%.
Both genders reported a negative body image.
The researchers observed that patients seldom remembered discussing sexual risks preoperatively and seldom were treated for dysfunction.
Current age, surgical procedure, and preoperative sexual activity were independently associated with current sexual activity.
The team found that male gender, surgical procedure, and radiation therapy were independently associated with the outcome "surgery made sexual life worse."
Dr Hendren's team concludes, “Sexual problems after surgery for rectal cancer are common, multifactorial, inadequately discussed, and untreated.”
“Therefore, sexual dysfunction should be discussed with rectal cancer patients, and efforts to prevent and treat it should be increased.”