A Study Of Urinary Function And Male Sexual Function After Total Mesorectal Excision With Pelvic Autonomic Nerve Preservation

Objective:To investigate the effect of total mesorectal excision(TME)and pelvic autonomic nerve(PANP)on postoperative urinary function and male sexual function in patients with rectal cancer,and to elucidate the relationship between age,sex,tumor location,TNM staging On postoperative functional recovery,and to further evaluate the clinical significance of TME + PANP in radical resection of rectal cancer.Methods: A prospective cohort study was conducted to analyze the patients undergoing colorectal cancer treated by the same treatment group in the General Hospital of Ningxia Medical University Hospital colorectal surgery.In the study of urinary function,all enrolled cases were included in September 2014 to April 2016,followed up for 6 months,88 patients was obtained eventually,comparison the differences between preoperative and postoperative and the differences between the different groups.In the study of sexual function,all enrolled cases were enrolled from September 2014 to February 2016,and the follow-up time was 1 year,25 patients was obtained eventually,comparison the differences between preoperative and postoperative and the differences between the different groups.Results:1.The influence of urinary function after TME+PANP.1.1 The incidence of urinary dysfunction:At 1 week,3 months and 6 months after operation,the incidence of urinary dysfunction was 23.64%,14.55% and 10.91% in male patients.At 1 week,3 months and 6 months after operation,the incidence of urinary dysfunction was 23.64%,14.55% and 10.91% in female patients.1.2 Changes in postoperative urinary function:patients with urinary function in 1 week after surgery,3 months after surgery worse than before surgery,there was a significant difference(P <0.05);In 6 months after surgery,no Statistical differences(P> 0.05).1.3 Comparison of postoperative urinary function between different groups:Male patients with postoperative voiding function worse than female patients and the two groups were statistically significant(P <0.05).In the male patient group,there was a significant difference in the low age group(? 60 years old)and the old group(> 60 years old).In the female patient group,there was no significant difference.There was no significant difference in urinary function between different tumor location and clinical stage(P> 0.05).2.The influence of male sexual function after TME+PANP.2.1 The incidence of male sexual dysfunction:At 3 months after operation,the incidence of low libido,Erectile dysfunction,ejaculation dysfunction was 28%?40%?44%.At 6 months after operation,the incidence of low libido,Erectile dysfunction,ejaculation dysfunction was 8%?32%?32%.After 1 year after operation,the incidence of low libido,Erectile dysfunction,ejaculation dysfunction was 0%?24%?28%.2.2 Changes in postoperative sexual function:The scores of sexual function were decreased at 3 months,6 months and 1 year after operation than the preoperative score,and there was statistical difference(P<0.05).2.3 Comparison of postoperative male sexual function between different groups:There were statistically significant differences(P <0.05)between tumor location,and age at 3 months,6 months and 1 year after operation.There were no significant differences in TNM staging between different periods after operation.Conclusion:TME+PANP can minimize the impact of surgery on urinary function and sexual function,Therefore,the precision surgery like TME + PANP should be promoted,in ensuring the basis of radical treatment,as far as possible to retain the function,improve the quality of life of patients.