METHODS: We conducted a prospective study on 91 patients who were diagnosed with sigmoid colon and rectal cancers and underwent laparoscopic surgery during 2014-2016. Voiding and male and female sexual dysfunctions following surgery were evaluated by the International Prostate Symptom Score (IPSS), International Index of Erectile Function-5 (IIEF-5), and Female Sexual Function Index-6 (FSFI-6), respectively. Urogenital function was compared at pre-surgery and 3 and 12 months postoperatively, and factors associated with urogenital dysfunction were identified.
RESULTS: The overall urinary function after surgery was better when compared to that at pre-surgery; however, there was deterioration in both male and female sexual functions. The mean preoperative IPSS, IIEF-5, and FSFI-6 scores were 9.35, 12.18, and 6.09, respectively. The mean differences among IPSS, IIEF-5, and FSFI-6 at 12 months postoperatively and pre-surgery were -3.08 (95% confidence interval [CI] -4.77 to -1.40), -2.57 (95% CI -4.33 to -0.80), and -2.58 (95% CI -4.73 to 0.42), respectively. Multivariate analysis demonstrated that age ≤60 years (odds ratio 4.22) and postoperative complications (odds ratio 2.77) were correlated with erectile dysfunction.
CONCLUSIONS: Voiding function improved after laparoscopic surgery in both sigmoid colon and rectal cancer patients. However, sexual function in both male and female patients was worse. Age ≤60 years and postoperative complications were strongly associated with male sexual dysfunction.
方法:我们在2014-2016年期间对91例诊断为乙状结肠和直肠癌并接受腹腔镜手术的患者进行了前瞻性研究。通过国际前列腺症状评分(IPSS)评估排尿和手术后男性和女性性功能障碍,国际勃起功能指数-5(IIEF-5),女性性功能指数-6(FSFI-6),分别。术前、术后3个月和12个月比较泌尿生殖功能,并确定了与泌尿生殖功能障碍相关的因素。
结果:与手术前相比,手术后的整体排尿功能更好;然而,男性和女性的性功能都有恶化。术前平均IPSS,IIEF-5和FSFI-6评分分别为9.35、12.18和6.09。IPSS之间的平均差异,术后12个月和手术前IIEF-5和FSFI-6分别为-3.08(95%置信区间[CI]-4.77至-1.40),-2.57(95%CI-4.33至-0.80),和-2.58(95%CI-4.73至0.42),分别。多因素分析表明,年龄≤60岁(比值比4.22)和术后并发症(比值比2.77)与勃起功能障碍有关。
结论:乙状结肠和直肠癌患者腹腔镜手术后排尿功能均有改善。然而,男性和女性患者的性功能均较差。年龄≤60岁,术后并发症与男性性功能障碍密切相关。