Anorektal-, Blasen und Sexualfunktionsstörungen sowie Lebensqualität bei Frauen nach Rektumresektion im Vergleich zur Kolonresektion bei Karzinom
Following the introduction of total mesorectal excision (TME) of the rectum the incidence of postoperative anorectal-, bladder-, and sexual dysfunction in men seems to be reduced. Very few data exist for women. The aim of this study was to establish the incidence of potential postoperative pelvic dysfunction in women after excision of rectal cancer. These dysfunctions are mainly the result of damage to the autonomic pelvic nerves. Our study was retrospective and evaluated urogenital and anorectal function after transabdominal rectal resection (TAR) with total mesorectal excision (TME) for cancer with standardized questionnaires, urinary function studies and anal manometry. We included women with TME or colonic resection who underwent surgery between 2000 and 2003 at the University Hospital Aachen. The TME group represented the study group. The colonic group served as a control. Exclusion criteria were perineal rectal excision, tumor stage T4, metastatic disease, age over 70 years at time of the survey, local recurrence, anastomotic insufficiency, radiotherypy, presence of colostomy, immobility, neural disease affecting pelvic function. The study group (TAR with TME) included 15 women, the control group (colonic resection) 11 women. The standardized and validated King’s Health questionnaire, Wexner continence score, Female Sexual Function Index (FSFI) and a general questionnaire were sent to all patients. Unfortunately, only five women underwent urinary function studies and four underwent anal manometry. We regard this number as non-representative and therefore we just describe these findings without statistical analysis. We found a statistically significant reduction of anorectal function. Sexual function was only significantly reduced in the categories arousal and lubrication for the rectal group. Conclusion: After rectal excision women showed significant impairment of their anorectal function. Urinary and sexual function were normal. This is in contrast to the incidence of dysfunction in men which is reported in up to 60%. In view of the fact that most patients are elderly and lost interest in sex one has to interpret sexual data with caution. Nevertheless urinary function certainly showed no impairment. Altogether women seem to have less functional problems compared to men.
info:eu-repo/classification/ddc/610, Mastdarmkrebs, Frau, Sexualstörung, Lebensqualität, Medizin, anorektale Funktionsstörungen, urogenitale Funktionsstöurngen, Rektumresektion, urogenital dysfunction, anorectal dysfunction, quality of life, rectum resection, rectal cancer, women
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