Sexual Function After a Proctectomy for the Treatment of Rectal Cancer

1. Kim NK, Min BS, Kim JS, Hur H, Lee KY, Sohn SK, et al. Oncologic outcomes and safety after tumor-specific mesorectal excision for resectable rectal cancer: a single institution’s experience with 1,276 patients with rectal cancer. J Korean Soc Coloproctol 2008;24:121-33. 2. Min HS, Kim JY. Health-related quality of life of patients with rectal cancer. J Korean Soc Coloproctol 2009;25:100-6. 3. Won SL, Kim IY, Sung SH, Kim DS. Functional and oncologic outcome of coloanal anastomosis in low lying rectal cancer. J Korean Soc Coloproctol 2005;21:419-25. 4. Attaallah W, Ertekin C, Tinay I, Yegen C. High rate of sexual dysfunction following surgery for rectal cancer. Ann Coloproctol 2014; 30:210-5. 5. Ho VP, Lee Y, Stein SL, Temple LK. Sexual function after treatment for rectal cancer: a review. Dis Colon Rectum 2011;54:11325. The incidence of anal-sphincter-preservation surgery for the treatment of rectal cancer has increased since the popularization of a total mesorectal excision with pelvic autonomic nerve preservation based on a better understanding of the pelvic anatomy [1]. In recent years, both colorectal surgeons and cancer patients have given increased attention to the quality of life after rectal-cancer surgery [2]. A well-preserved function is directly related to better quality of life. Functional outcomes after rectal-cancer surgery include voiding, sexual function, and defecation [3]. However, sexual function has often been neglected in the conservative societies such as that in Korea. In this regard, Attaallah et al. [4] presented a timely paper in this issue of the Annals of Coloproctology. The authors evaluated sexual dysfunction after rectal-cancer surgery by using a questionnaire and found that postoperative sexual dysfunctions were common and that women were at high risk for sexual dysfunction. This study is valuable in that sexual function in men and women has rarely been studied. However, inherent limitations, such as small sample size and a cross-sectional study, still exist. In a recent review by Ho et al. [5], deterioration of sexual function after rectal-cancer surgery was observed in 23% to 69% of men and 19% to 62% of women. However, potential contributing factors (either treatmentor patient-related) to, the duration of, and the treatment for sexual dysfunction are still under debate. Standardized and validated evaluation tools are lacking. Previous studies used questionnaire surveys, but various types of question-