Late pelvic function following rectal cancer resection – a case-control study
BACKGROUND: There are still controversial data about the impact of rectal resection for malignancies on overall pelvic organ function and quality of life. Our aim was to investigate whether these parameters differ compared to the general population without bowel resection. METHODS: One hundred eighteen patients (44%) operated for rectal cancer at a single institution between 1995 and 2005 completed a self-administering questionnaire including the International Index of Erectile Function, Female Sexual Function Index, Short Form-12 Health Survey, International Prostatic Symptom Score, International Consultation on Incontinence Questionnaire-Short Form, and Vaizey Incontinence Score. Healthy subjects with no bowel resection served as controls for each case and were matched by age (±5 years) and gender. The median follow-up time was 7 years (range 2.8–14.2). RESULTS: The Vaizey incontinence score was significant higher in the patient group compared with the control group (patients: median 4 (range 0–24), controls: 0 (range 0–20); p<0.0001). Sexual and urinary function showed no significant difference between both groups. In regard to the SF-12 health survey the median physical health score of patients was 51.5 (range 22.0–58.2) compared to 53.6 (range 16.8–64.3) of the control subjects (p = 0.1241). The median mental health score of the patient group was 55.1 (range 19.1–63.8) compared to 55.0 (range 28.7–63.8) of the control group (p = 0.2222). CONCLUSIONS: Patients with rectal cancer resection have a significant impairment of fecal continence. Notably, urinary and sexual function and quality of life are comparable with healthy subjects without colorectal resection.