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Medical Forum / Diseases and Disorders / Cancer / April 2004APR (colon) & sexual dysfunction
Dear group, Does anyone have any ideas about APR and the rate of sexual dysfunction following the procedure? I've read on some websites that it occurs about 40 percent of the time due to the proximity of a nerve bundle to the rectal area. I've also read that rates are, in actuality, much lower than this. If anyone can add just what, precisely, the dysfunction _is_, I'd sincerely appreciate it. Thanks for your time, Best, Morgs. > Dear group, > Does anyone have any ideas about APR and the rate of sexual dysfunction [quoted text clipped - 6 lines] > Best, > Morgs. Hello Morgs, It's my understanding that the rectum is close to the prostate. I see "nerve sparing" surgery discussed on the prostate cancer newsgroup. Some mention loss of capability of erection (ED - erectile dysfunction) if damage or loss of some nerves. - doesn't happen to every one of them though. And I don't know if "nerve sparing" is possible in your husband's situation. Not to mention how radiation therapy might affect such - a question for the radiation oncologist. There are some medications that sometimes help with that or various other methods mentioned here. http://www.treatments-for-erectile-dysfunction.com/html/erection-aids.php3 This web page mentions http://www.colorectal-cancer.net/surgeryrectalcancer.htm Many patients would like to avoid a permanent colostomy. When the rectal cancer lies close to the sphincter or anus, an APR is typically recommended. In some instances, a more limited surgery can be used avoiding a colostomy, or radiation therapy can be used to shrink the rectal cancer prior to surgery allowing the patient to maintain control of bowel function. Some small rectal cancers that lie close to the anus can be removed with less extensive surgery, called a local excision. Not all patients can undergo a local excision (see Local Excision below). Patients undergoing an APR may experience lower abdominal pain after the operation. Less common complications related to surgery include bleeding, infection, slow wound healing, and temporary difficulty with emptying the bladder. Some men may experience sexual dysfunction after surgery. Ask the surgeon to explain the various complications and their frequency of occurrence at the hospital where the surgery will be performed." Which I think is excellent advice ! I'm not sure that you'll ever find definitive percentages (and/or they'll vary). And your husband is 100% of him, in other words each situation is very individual. I suppose you could ask each surgeon their rate of success, if known, if you see more than one. I know some posters get 2nd opinions, especially on surgeries. That will be up to your husband and you. Perhaps your husband just wants to get on with it. Some people get more nervous the longer the wait, so let's see what happens after the meeting Monday and do take a short list of questions to ask. Keep in touch, Hope this helps somehow. J . > > Dear group, > > Does anyone have any ideas about APR and the rate of sexual dysfunction [quoted text clipped - 14 lines] > "nerve sparing" is possible in your husband's situation. Not to mention how > radiation therapy might affect such - a question for the radiation oncologist. > There are some medications that sometimes help with that or various other > methods mentioned here. > http://www.treatments-for-erectile-dysfunction.com/html/erection-aids.php3 > > This web page mentions http://www.colorectal-cancer.net/surgeryrectalcancer.htm Thanks, J. > Many patients would like to avoid a permanent colostomy. When the rectal cancer > lies close to the sphincter or anus, an APR is typically recommended. In some [quoted text clipped - 4 lines] > called a local excision. Not all patients can undergo a local excision (see > Local Excision below). The surgeon says that radio/chemo pre-surgery can eliminate the tumor, but he prefers to perform surgery regardless to make sure the cancer is gone. In other words, he wants to perform an APR regardless, which is something I understand (why take chances that the radio/chemo didn't get _all_ of the cancer). > Patients undergoing an APR may experience lower abdominal pain after the > operation. Less common complications related to surgery include bleeding, [quoted text clipped - 3 lines] > at the hospital where the surgery will be performed." Which I think is > excellent advice ! It is, absolutely. I am grateful for the question suggestions, as I tend to get tongue-tied and can't even read my list. I have to confess that I'm not sure the surgeon listens to me--I'm the nosy wife, you know?--becasue he kept brushing off my attempts and refocusing on Baz. I tihnk I'll print off a list of such questions and give them to my husband to ask. > I'm not sure that you'll ever find definitive percentages (and/or they'll > vary). And your husband is 100% of him, in other words each situation is very > individual. I suppose you could ask each surgeon their rate of success, if > known, if you see more than one. I like the 100%. > I know some posters get 2nd opinions, especially on surgeries. That will be up > to your husband and you. Perhaps your husband just wants to get on with it. [quoted text clipped - 4 lines] > J > . You've helped tremendously. Sincerely, thank you J. > Dear group, > Does anyone have any ideas about APR and the rate of sexual dysfunction [quoted text clipped - 6 lines] > Best, > Morgs. 40% is about right. The figures vary depending on: a) the surgeon b) the tumour and c) how diligently problems are recorded after treatment > > Dear group, > > Does anyone have any ideas about APR and the rate of sexual [quoted text clipped - 12 lines] > 40% is about right. The figures vary depending on: a) the surgeon b) the > tumour and c) how diligently problems are recorded after treatment Steph, How do you mean by "how diligently problems are recorded after treatment"? I don't want to misunderstand. Do you mean a) not all post-surgery results are recorded (thus missing out on some cases) or b) sexual dysfunction can occur due to post-surgery problems? Thank you. Best, Morgs > Steph, > How do you mean by "how diligently problems are recorded after treatment"? I [quoted text clipped - 4 lines] > Best, > Morgs Unfortunately, unless post surgical problems are very systematically recorded after surgery, they aren't recorded at all! Surgical series in the literature are notoriously bad at objectively recording treatment side-effects (non-surgical series aren't much better...) Your a) is correct |
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