期刊
COLORECTAL DISEASE
卷 17, 期 1, 页码 26-37出版社
WILEY
DOI: 10.1111/codi.12758
关键词
Rectal cancer; urinary dysfunction; sexual dysfunction; low anterior resection; abdominoperineal excision; preoperative radiotherapy
资金
- Danish Cancer Society
- Council for Health Research in the Central Denmark Region
- Boels Foundation
- Danish Cancer Research Foundation
- Spogard Family Foundation
AimKnowledge of urinary and sexual dysfunction in women after rectal cancer treatment is limited. This study addresses this in relation to the use of preoperative radiotherapy, type of surgery and the presence of bowel dysfunction. MethodAll living female patients who underwent abdominoperineal excision (APE) or low anterior resection (LAR) for rectal cancer in Denmark between 2001 and 2007 were identified. Validated questionnaires (the ICIQ-FLUTS and the SVQ) on urinary and sexual function were completed by 516 (75%) and 482 (72%) recurrence-free patients in 2009. ResultsUrgency and incontinence were reported by 77 and 63% of respondents, respectively. Vaginal dryness, dyspareunia and reduced vaginal dimensions occurred in 72, 53 and 29%, respectively, and 69% reported that they had little/no sexual desire. Preoperative radiotherapy was associated with voiding difficulties (OR=1.63, 95% CI 1.09-2.44), reduced vaginal dimensions (OR=4.77, 95% CI 1.97-11.55), dyspareunia (OR=2.76, 95% CI 1.12-6.79), lack of desire (OR=2.22, 95% CI 1.09-4.53) and reduced sexual activity (OR=0.55, 95% CI 0.30-0.98). Patients undergoing APE had a higher risk of dyspareunia (OR=2.61, 95% CI 1.00-6.85). Bowel dysfunction after LAR was associated with bladder storage difficulties (OR=1.64, 95% CI 1.01-2.65), symptoms of incontinence (OR=2.17, 95% CI 1.35-3.50), lack of sexual desire (OR=2.69, 95% CI 1.21-5.98), sexual inactivity (OR=0.48, 95% CI 0.24-0.96) and sexual dissatisfaction (OR=0.40, 95% CI 0.20-0.82). ConclusionUrinary and sexual problems are common in women after treatment for rectal cancer. Preoperative radiotherapy interferes with several aspects of urinary and sexual functioning. Bowel dysfunction after LAR is associated with urinary dysfunction and a reduction in sexual desire, activity and satisfaction.
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