Katrine J Emmertsen

Female urinary and sexual dysfunction after resection with and without preoperative radiotherapy for rectal cancer: a population-based cross-sectional study

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AIM: Knowledge of female urinary and sexual dysfunction after rectal cancer treatment is limited. This study addresses this in relation to the use of preoperative radiotherapy, type of surgery and presence of bowel dysfunction.

METHOD: All living female patients who underwent abdominoperineal resection (APR) or low anterior resection (LAR) for rectal cancer in Denmark in 2001-2007 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.

RESULTS: Urgency and incontinence were reported by 77% and 63%. Vaginal dryness, dyspareunia and reduced vaginal dimensions occurred in 72%, 53% and 29%, 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 APR 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), incontinence symptoms (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).

CONCLUSION: Female urinary and sexual problems are common after rectal cancer treatment. 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. This article is protected by copyright. All rights reserved.

TidsskriftColorectal Disease
Sider (fra-til)26-37
Antal sider11
StatusUdgivet - 1 jan. 2015

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