Effectiveness of Partial Autonomic Nerve Preservation Surgery for Sexual Function in the Male in the Advanced Rectal Cancers

ABSTRACT

BACKGROUND: During the past eight years, we have been performing partial autonomic nerve preservation surgery (PANP) for the treaolent of advanced rectal cancer in order to reduce the postoperative male sexual dysfunctions. METHODS: This is a prospective study of 25 rectal cancer patients who underwent PANP from 1990 to 1997. All patient were in Duke C stage and their ages were between 30 and 55. Patients were divided into four types: 1) Partial sacrifice of inferior mesenteric plexus (PSIP). 2) Partial sacrifice of preaortic nerve (PSPN). 3) Complete sacrifice of preaortic nerve with complete pelvic nerve preservation (CSPN). 4) Unilateral sacrifice of pelvic autonomic nerve (USPN). RESULTS: The percentage of ejaculation and erection difficulties at each surgery was as follows: PSIP 0/5 (0%) for ejaculation vs. 0/5 (0%) for erection, respectively, PSPN 5/7 (71.4%) vs. 2/7 (28.6%), CSPN 6/7 (85.7%) vs. 0/7 (0%) and USPN 6/6 (100%) vs. 5/6 (83.3%). Summary: PANP is possible for the treatment of advanced rectal cancer.