Urogenital function following laparoscopic and open rectal cancer resection: a comparative study

Surgical Endoscopy, 04/12/2012

Laparoscopic total mesorectal excision for rectal cancer is associated with significantly less deterioration in sexual function compared with open surgery. This effect is particularly pronounced in women.


  • All patients who underwent elective laparoscopic or open surgery for rectal cancer between September 2006 and September 2009 were identified from a prospectively collated database.
  • Validated standardized postal questionnaires were sent to surviving patients to assess their postoperative sexual and urinary function.
  • The functional data were then quantified using previously validated indices of function.


  • A total of 173 patients were identified from the database, of whom 144 (83 %) responded to the questionnaire–based study.
  • Seventy–eight respondents had undergone laparoscopic rectal resection (49 men and 29 women), and 65 had an open procedure (41 men and 24 women).
  • Both open surgery and laparoscopic surgery were associated with deterioration in urinary and sexual function.
  • With regard to urinary function, there was no difference in the deterioration in open and laparoscopic groups in either gender.
  • With regard to sexual function, in males one component of sexual function, namely, the incidence of successful penetration, showed less deterioration in the laparoscopic group (p = 0.04).
  • However, in females, laparoscopic surgery was associated with significantly better outcomes in all aspects of sexual activity, specifically sexual arousal (p = 0.005), lubrication (p = 0.001), orgasm (p = 0.04), and the incidence of dyspareunia (p = 0.02).

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