Male Sexual Function Following Resection for Rectal Cancer

Yoshinori Shirai, Hiromi Sarashina, Norio Saitoh, Masao Nunomura, Katsuji Okui

First Department of Surgery, School of Medicine, Chiba University

Sexual function was evaluated after personal interview in 33 male patients and after examination of sexual function in 6 of these, in whom resection for carcinoma of the rectum with preservation of pelvic plexus nerves and/or hypogastric nerves was performed. From the results of questionnaire, total impotence was found to have occurred in 18.2%, and no inability to ejaculate in 66.7%. Sexual dysfunction occurred at high incidence in the group of patients who had undergone extensive lymph node dissection and abdominoperineal resection. In 14 patients in whom neither the hypogastric nerves nor the pelvic plexus nerves were injured, 7.1% total impotence, and 21.4% had ejaculatory inability. From the results of examination of sexual function, in 3 of 5 patients, the level of follicle-stimulating hormone was elevated. Penile blood pressure index was not decreased in 5 patients postoperatively. Semen was reduced in all patients. It is suggested that pelvic autonomic nerve-preserving operations should be undertaken only in cases preoperatively diagnosed as relatively early stage carcinoma of the rectum, and that examinations are useful for the evaluation of male sexual function.

Key words
rectal cancer, male sexual dysfunction, pelvic autonomic preserving operation

Reprint requests
Yoshinori Shirai First Department of Surgery, School of Medicine, Chiba University
1-8-1 Inohana Chiba, 280 JAPAN

Accepted
November 19, 1990

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