Kolokotronis T, Pantelis D. Urinary and sexual dysfunction after rectal cancer surgery: A surgical challenge. World J Gastroenterol 2024; 30(47): 5081-5085 [PMID: 39713160 DOI: 10.3748/wjg.v30.i47.5081]
Corresponding Author of This Article
Theodoros Kolokotronis, MD, Consultant Physician-Scientist, Department of Surgery and Centre of Minimal Invasive Surgery, GFO Kliniken Bonn, St. Josef Hospital Bonn-Beuel, Hermann Str. 37, Bonn 53225, North Rhine-Westphalia, Germany. fernado13984@yahoo.gr
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Dec 21, 2024; 30(47): 5081-5085 Published online Dec 21, 2024. doi: 10.3748/wjg.v30.i47.5081
Urinary and sexual dysfunction after rectal cancer surgery: A surgical challenge
Theodoros Kolokotronis, Dimitrios Pantelis
Theodoros Kolokotronis, Dimitrios Pantelis, Department of Surgery and Centre of Minimal Invasive Surgery, GFO Kliniken Bonn, Bonn 53225, North Rhine-Westphalia, Germany
Author contributions: Kolokotronis T conceived the design of the experiment, analyzed the data and wrote the manuscript; Pantelis D critically revised the manuscript.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Theodoros Kolokotronis, MD, Consultant Physician-Scientist, Department of Surgery and Centre of Minimal Invasive Surgery, GFO Kliniken Bonn, St. Josef Hospital Bonn-Beuel, Hermann Str. 37, Bonn 53225, North Rhine-Westphalia, Germany. fernado13984@yahoo.gr
Received: August 9, 2024 Revised: October 24, 2024 Accepted: November 7, 2024 Published online: December 21, 2024 Processing time: 108 Days and 14.9 Hours
Abstract
This manuscript focused on the surgical challenge of urinary and sexual dysfunction after rectal cancer surgery based on the interesting results demonstrated by the observational study of Chen et al, which was published in the World Journal of Gastrointestinal Surgery. Urinary dysfunction occurs in one-third of patients treated for rectal cancer. Surgical nerve damage is the main cause of urinary dysfunction. Radiotherapy seems to exacerbate sexual dysfunction. The role of Denonvilliers' fascia preservation vs resection when performing total mesorectal excision (TME), the impact of robotic and transanal TME, alternatives to open and laparoscopic TME, as well as intraoperative pelvic neuromonitoring are discussed in this report. In conclusion, exact knowledge of the highly complex pelvic neuroanatomy and the use of novel surgical techniques can lead to a reduction in urinary and sexual dysfunction after rectal cancer surgery.
Core Tip: Urinary and sexual dysfunction have a significant negative impact on patient quality of life after rectal cancer surgery. New surgical techniques include robotic and transanal total mesorectal excision and intraoperative pelvic neuromonitoring. Knowledge of complex pelvic neuroanatomy, as well as the use of novel surgical techniques, can reduce the incidence of these complications.
