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Self-reported sexual dysfunction in patients with rectal cancer

Journal article
Authors M. Sorensson
Dan Asplund
P. Matthiessen
J. Rosenberg
T. Hallgren
Carina Rosander
Elisabeth Gonzalez
David Bock
Eva Angenete
Published in Colorectal Disease
Volume 22
Issue 5
Pages 500-512
ISSN 1462-8910
Publication year 2020
Published at Institute of Clinical Sciences, Department of Surgery
Pages 500-512
Language en
Links dx.doi.org/10.1111/codi.14907
Keywords Rectal neoplasm, sexual function, surgery, radiotherapy, quality-of-life, abdominoperineal excision, urinary dysfunction, colorectal-cancer, surgery, radiotherapy, resection, women, trial, Gastroenterology & Hepatology, Surgery
Subject categories Gastroenterology and Hepatology, Surgery

Abstract

Aim Patients with rectal cancer often experience sexual dysfunction after treatment. The aim of this study was to evaluate sexual function in a prospective cohort of patients regardless of treatment and tumour stage and explore what factors might affect sexual activity 1 year after diagnosis. Method The QoLiRECT study (Quality of Life in RECTal cancer) is a prospective study on the health-related quality of life in patients with rectal cancer in Denmark and Sweden. Questionnaires were completed at diagnosis and 1 year. Clinical data were retrieved from national quality registries. Results Questionnaire data were available from 1085 patients at diagnosis and 920 patients at 1 year. Median age was 69 years (range 25-100). At diagnosis, 29% of the women and 41% of the men were sexually active, which was lower than an age-matched reference population. This was further reduced to 25% and 34% at 1 year. Risk factors for sexual inactivity were absence of sexual activity prior to the diagnosis and the presence of a stoma. Women experienced reduced lubrication and more dyspareunia at 1 year compared with the time of diagnosis. In men, erectile dysfunction increased from 46% to 55% at 1 year. Conclusion Sexual activity in patients with rectal cancer is lower at diagnosis compared with the population norm and is further reduced at 1 year. The presence of a stoma contributed to reduced sexual activity after operation. Sexual dysfunction was difficult to evaluate due to low sexual activity in the cohort. In men, erectile dysfunction is common.

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