Self reported experience of sexual function and quality after abdominoperineal excision in a prospective cohort

• Sexual function is impaired after rectal cancer surgery.
• This study adds information on the bother perceived by patients with sexual impairment after rectal cancer surgery.
• This study also confirms previous data that patients do not feel adequately informed about possible sexual impairment.
• We have shown that men are more bothered by their sexual impairment than women.

Introduction: Rectal cancer treatment, especially abdominoperineal excision (APE), can cause sexual dysfunction. There are indications that pre-operative information regarding sexual dysfunction is inadequate. The aim of this study was to explore self reported sexual function in a group of patients operated with APE and the patients' remembrance of preoperative information more than one year after their surgical procedure. Methods: Consecutive patients with rectal cancer operated with APE in one institution between 2004 and 2009 were included. Data was collected from hospital records and the Swedish Colorectal cancer registry. A detailed questionnaire was sent out to the patients 13–84 months post-operatively. Results: One hundred and eight patients were alive in February 2011, 84 agreed to participate and 89% returned the questionnaire. Men and women did not differ regarding age, tumour stage, neoadjuvant treatment or type of surgical procedure. More men were involved in a relationship; men had more thoughts about sex, were less satisfied and were more bothered than women by their sexual dysfunction. A majority of patients did not retain sufficient knowledge from the preoperative information regarding sexual dysfunction. Discussion: This exploratory study shows that although sexual activity was similar between the two genders, men reported more bother by their self-reported sexual dysfunction after an APE than women did. However, both men and women felt that the preoperative information was inadequate. Conclusion: Surgeons should focus more on information about the risk of sexual dysfunction as well as on its treatment at follow-up.Trial registrationClinicalTrials.gov, NCT01323166.