Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique

Background: Bladder and sexual dysfunction are recognized complications of mesorectal resection. Their incidence following laparoscopic surgery is unknown. Methods: Bladder and sexual function were assessed in patients who had undergone laparoscopic rectal, open rectal or laparoscopic colonic resect...

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Veröffentlicht in:British journal of surgery 2005-09, Vol.92 (9), p.1124-1132
Hauptverfasser: Jayne, D. G., Brown, J. M., Thorpe, H., Walker, J., Quirke, P., Guillou, P. J.
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container_end_page 1132
container_issue 9
container_start_page 1124
container_title British journal of surgery
container_volume 92
creator Jayne, D. G.
Brown, J. M.
Thorpe, H.
Walker, J.
Quirke, P.
Guillou, P. J.
description Background: Bladder and sexual dysfunction are recognized complications of mesorectal resection. Their incidence following laparoscopic surgery is unknown. Methods: Bladder and sexual function were assessed in patients who had undergone laparoscopic rectal, open rectal or laparoscopic colonic resection as part of the UK Medical Research Council Conventional versus Laparoscopic‐Assisted Surgery In Colorectal Cancer (CLASICC) trial, using the International Prostatic Symptom Score, the International Index of Erectile Function and the Female Sexual Function Index. Sexual and bladder function data from the European Organization for Research and Treatment of Cancer QLQ‐CR38 collected in the CLASICC trial were used for comparison. Results: Two hundred and forty‐seven (71·2 per cent) of 347 patients completed questionnaires. Bladder function was similar after laparoscopic and open rectal operations for rectal cancer. Overall sexual function and erectile function tended to be worse in men after laparoscopic rectal surgery than after open rectal surgery (overall function: difference − 11·18 (95 per cent confidence interval (c.i.) −22·99 to 0·63), P = 0·063; erectile function: difference −5·84 (95 per cent c.i. −10·94 to −0·74), P = 0·068). Total mesorectal excision (TME) was more commonly performed in the laparoscopic rectal group than in the open rectal group. TME (odds ratio (OR) 6·38, P = 0·054) and conversion to open operation (OR 2·86, P = 0·041) were independent predictors of postoperative male sexual dysfunction. No differences were detected in female sexual function. Conclusion: Laparoscopic rectal resection did not adversely affect bladder function, but there was a trend towards worse male sexual function. This may be explained by the higher rate of TME in the laparoscopic rectal resection group. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Trend towards worse outcome in men
doi_str_mv 10.1002/bjs.4989
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G. ; Brown, J. M. ; Thorpe, H. ; Walker, J. ; Quirke, P. ; Guillou, P. J.</creator><creatorcontrib>Jayne, D. G. ; Brown, J. M. ; Thorpe, H. ; Walker, J. ; Quirke, P. ; Guillou, P. J.</creatorcontrib><description>Background: Bladder and sexual dysfunction are recognized complications of mesorectal resection. Their incidence following laparoscopic surgery is unknown. Methods: Bladder and sexual function were assessed in patients who had undergone laparoscopic rectal, open rectal or laparoscopic colonic resection as part of the UK Medical Research Council Conventional versus Laparoscopic‐Assisted Surgery In Colorectal Cancer (CLASICC) trial, using the International Prostatic Symptom Score, the International Index of Erectile Function and the Female Sexual Function Index. Sexual and bladder function data from the European Organization for Research and Treatment of Cancer QLQ‐CR38 collected in the CLASICC trial were used for comparison. Results: Two hundred and forty‐seven (71·2 per cent) of 347 patients completed questionnaires. Bladder function was similar after laparoscopic and open rectal operations for rectal cancer. Overall sexual function and erectile function tended to be worse in men after laparoscopic rectal surgery than after open rectal surgery (overall function: difference − 11·18 (95 per cent confidence interval (c.i.) −22·99 to 0·63), P = 0·063; erectile function: difference −5·84 (95 per cent c.i. −10·94 to −0·74), P = 0·068). Total mesorectal excision (TME) was more commonly performed in the laparoscopic rectal group than in the open rectal group. TME (odds ratio (OR) 6·38, P = 0·054) and conversion to open operation (OR 2·86, P = 0·041) were independent predictors of postoperative male sexual dysfunction. No differences were detected in female sexual function. Conclusion: Laparoscopic rectal resection did not adversely affect bladder function, but there was a trend towards worse male sexual function. This may be explained by the higher rate of TME in the laparoscopic rectal resection group. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. Trend towards worse outcome in men</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.4989</identifier><identifier>PMID: 15997446</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley &amp; Sons, Ltd</publisher><subject>Aged ; Biological and medical sciences ; Digestive system. Abdomen ; Endoscopy ; Erectile Dysfunction - etiology ; Female ; General aspects ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Laparoscopy - adverse effects ; Male ; Medical sciences ; Patient Satisfaction ; Rectal Neoplasms - surgery ; Sex Factors ; Sexual Dysfunction, Physiological - etiology ; Sexual Dysfunction, Physiological - physiopathology ; Treatment Outcome ; Urinary Bladder Diseases - etiology ; Urinary Bladder Diseases - physiopathology</subject><ispartof>British journal of surgery, 2005-09, Vol.92 (9), p.1124-1132</ispartof><rights>Copyright © 2005 British Journal of Surgery Society Ltd. 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G.</creatorcontrib><creatorcontrib>Brown, J. M.</creatorcontrib><creatorcontrib>Thorpe, H.</creatorcontrib><creatorcontrib>Walker, J.</creatorcontrib><creatorcontrib>Quirke, P.</creatorcontrib><creatorcontrib>Guillou, P. J.</creatorcontrib><title>Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background: Bladder and sexual dysfunction are recognized complications of mesorectal resection. Their incidence following laparoscopic surgery is unknown. Methods: Bladder and sexual function were assessed in patients who had undergone laparoscopic rectal, open rectal or laparoscopic colonic resection as part of the UK Medical Research Council Conventional versus Laparoscopic‐Assisted Surgery In Colorectal Cancer (CLASICC) trial, using the International Prostatic Symptom Score, the International Index of Erectile Function and the Female Sexual Function Index. Sexual and bladder function data from the European Organization for Research and Treatment of Cancer QLQ‐CR38 collected in the CLASICC trial were used for comparison. Results: Two hundred and forty‐seven (71·2 per cent) of 347 patients completed questionnaires. Bladder function was similar after laparoscopic and open rectal operations for rectal cancer. Overall sexual function and erectile function tended to be worse in men after laparoscopic rectal surgery than after open rectal surgery (overall function: difference − 11·18 (95 per cent confidence interval (c.i.) −22·99 to 0·63), P = 0·063; erectile function: difference −5·84 (95 per cent c.i. −10·94 to −0·74), P = 0·068). Total mesorectal excision (TME) was more commonly performed in the laparoscopic rectal group than in the open rectal group. TME (odds ratio (OR) 6·38, P = 0·054) and conversion to open operation (OR 2·86, P = 0·041) were independent predictors of postoperative male sexual dysfunction. No differences were detected in female sexual function. Conclusion: Laparoscopic rectal resection did not adversely affect bladder function, but there was a trend towards worse male sexual function. This may be explained by the higher rate of TME in the laparoscopic rectal resection group. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley &amp; Sons, Ltd. Trend towards worse outcome in men</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Digestive system. Abdomen</subject><subject>Endoscopy</subject><subject>Erectile Dysfunction - etiology</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Laparoscopy - adverse effects</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Patient Satisfaction</subject><subject>Rectal Neoplasms - surgery</subject><subject>Sex Factors</subject><subject>Sexual Dysfunction, Physiological - etiology</subject><subject>Sexual Dysfunction, Physiological - physiopathology</subject><subject>Treatment Outcome</subject><subject>Urinary Bladder Diseases - etiology</subject><subject>Urinary Bladder Diseases - physiopathology</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0V9vFCEQAHBiNPZaTfwEhhd92wrL8u_Ra7TVXNREjYkvZJZllcrBFnZt6wfwc8ulV--FCcxvIMwg9IySU0pI-6q_LKedVvoBWlEmeNNSoR6iFSFENpS17Agdl3JJCGWEt4_REeVay64TK_R3HWAYXMYQB1zczQIBj0u0s08RjymEdO3jD5xdcfdnue7sXJ2FaGuljxhwrvVp6_-4Advgo7c1P2df1zTiABPkVGyavMW_XS5LwWlyEc_O_oz-anFP0KMRQnFP9_EEfX375svZRbP5eP7u7PWmsR3vdKOhA2By1GMPMBDFhdQd6USrRk0JV0OvKHO057JXelQcwFoJkrVEgpZSsRP08u7eKaf6bJnN1hfrQoDo0lKMUJx0nIkKn-_h0m_dYKbst5BvzX3nKnixB1DqZ8faAOvLwUkiuBK0uubOXfvgbg95YnaTM3VyZjc5s37_eRcP3pfZ3fz3kH8ZIZnk5tuHc6PJ981mLT8Zyf4B5S2boQ</recordid><startdate>200509</startdate><enddate>200509</enddate><creator>Jayne, D. 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Abdomen</topic><topic>Endoscopy</topic><topic>Erectile Dysfunction - etiology</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Laparoscopy - adverse effects</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Patient Satisfaction</topic><topic>Rectal Neoplasms - surgery</topic><topic>Sex Factors</topic><topic>Sexual Dysfunction, Physiological - etiology</topic><topic>Sexual Dysfunction, Physiological - physiopathology</topic><topic>Treatment Outcome</topic><topic>Urinary Bladder Diseases - etiology</topic><topic>Urinary Bladder Diseases - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jayne, D. G.</creatorcontrib><creatorcontrib>Brown, J. M.</creatorcontrib><creatorcontrib>Thorpe, H.</creatorcontrib><creatorcontrib>Walker, J.</creatorcontrib><creatorcontrib>Quirke, P.</creatorcontrib><creatorcontrib>Guillou, P. J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jayne, D. G.</au><au>Brown, J. M.</au><au>Thorpe, H.</au><au>Walker, J.</au><au>Quirke, P.</au><au>Guillou, P. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2005-09</date><risdate>2005</risdate><volume>92</volume><issue>9</issue><spage>1124</spage><epage>1132</epage><pages>1124-1132</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background: Bladder and sexual dysfunction are recognized complications of mesorectal resection. Their incidence following laparoscopic surgery is unknown. Methods: Bladder and sexual function were assessed in patients who had undergone laparoscopic rectal, open rectal or laparoscopic colonic resection as part of the UK Medical Research Council Conventional versus Laparoscopic‐Assisted Surgery In Colorectal Cancer (CLASICC) trial, using the International Prostatic Symptom Score, the International Index of Erectile Function and the Female Sexual Function Index. Sexual and bladder function data from the European Organization for Research and Treatment of Cancer QLQ‐CR38 collected in the CLASICC trial were used for comparison. Results: Two hundred and forty‐seven (71·2 per cent) of 347 patients completed questionnaires. Bladder function was similar after laparoscopic and open rectal operations for rectal cancer. Overall sexual function and erectile function tended to be worse in men after laparoscopic rectal surgery than after open rectal surgery (overall function: difference − 11·18 (95 per cent confidence interval (c.i.) −22·99 to 0·63), P = 0·063; erectile function: difference −5·84 (95 per cent c.i. −10·94 to −0·74), P = 0·068). Total mesorectal excision (TME) was more commonly performed in the laparoscopic rectal group than in the open rectal group. TME (odds ratio (OR) 6·38, P = 0·054) and conversion to open operation (OR 2·86, P = 0·041) were independent predictors of postoperative male sexual dysfunction. No differences were detected in female sexual function. Conclusion: Laparoscopic rectal resection did not adversely affect bladder function, but there was a trend towards worse male sexual function. This may be explained by the higher rate of TME in the laparoscopic rectal resection group. Copyright © 2005 British Journal of Surgery Society Ltd. 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source MEDLINE; Wiley Online Library Journals Frontfile Complete; Oxford University Press Journals All Titles (1996-Current)
subjects Aged
Biological and medical sciences
Digestive system. Abdomen
Endoscopy
Erectile Dysfunction - etiology
Female
General aspects
Humans
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopy - adverse effects
Male
Medical sciences
Patient Satisfaction
Rectal Neoplasms - surgery
Sex Factors
Sexual Dysfunction, Physiological - etiology
Sexual Dysfunction, Physiological - physiopathology
Treatment Outcome
Urinary Bladder Diseases - etiology
Urinary Bladder Diseases - physiopathology
title Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique
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