Kolokotronis T, Pantelis D. Urinary and sexual dysfunction after rectal cancer surgery: A surgical challenge. World J Gastroenterol 2024; 30(47): 5081-5085 [PMID: 39713160 DOI: 10.3748/wjg.v30.i47.5081]
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08398088
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December 03, 2024, 12:12
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Reader Comments:
he significant impact of surgical approaches on male sexual dysfunction after rectal cancer surgery is highlighted by both this letter to the editor and the latest study by Numata et al. published in Annals of Surgery1). Damage to the autonomic nervous system during rectal cancer surgery is a major cause of sexual dysfunction, with problems such as ejaculatory dysfunction, erectile dysfunction, and sexual dysfunction commonly reported. These complications are particularly common with open surgery, and previous research has also shown that the incidence of sexual dysfunction following surgery is high.
However, advances in surgical techniques such as robotic surgery are expected to reduce these complications. The LANDMARC Study provided convincing evidence that robotic surgery significantly reduces the incidence of postoperative sexual dysfunction compared to laparoscopic surgery. The incidence of ejaculatory dysfunction at 12 months postoperatively was 25% in robotic surgery patients compared to 40.9% in laparoscopic surgery patients. The incidence of sexual dysfunction was 17.8% and 29%, respectively.
This letter to editor alos emphasized the importance of accurate surgical technique and knowledge of pelvic nerve anatomy. It also discussed the benefits of new techniques such as robotic surgery and transanal total mesorectal excision (Ta-TME), as well as the use of intraoperative pelvic nerve monitoring. These advances enhance nerve preservation, reduce complications, and improve patients' postoperative quality of life.
These findings highlight the need to adapt innovative surgical techniques in rectal cancer treatment to minimize adverse effects on sexual health while maintaining oncologic effectiveness.
1) Numata, Masakatsu, et al. "Prospective Multicenter Comprehensive Survey on Male Sexual Dysfunction following Laparoscopic, Robotic, and Transanal Approaches for Rectal Cancer (the LANDMARC Study)." Annals of Surgery: 10-1097
Reply from the Editorial Office:
Thank you very much for your comments.