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Sexual dysfunctions following low anterior resection of the rectum in rectal cancer patients

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Włodarczyk M., Sobolewska J., Nowak A., Szewczyk M., Kluska P., Dzika K., Darnikowska J., Mik-Wojtczak J., Włodarczyk J., Sobolewska-Włodarczyk A., Trzciński R., Dziki Ł.
Polish Journal of Surgery
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2019
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vol. 91(3)
21-26
EN
Introduction. Low anterior resection of the rectum (LAR) is a treatment of choice in patients with diagnosed low rectal cancer. Rectal cancer surgery has a close relationship with the urinary-sexual organs and also with related nerves and nerve plexus. Thus, the sympathetic and parasympathetic nerves of the pelvic area may be damaged. As a result of this, the important point is the sexual function loss following rectal surgeries. The aim of the study was to investigate the sexual disorders in patients with rectal cancer who underwent LAR. Materials and methods. In this retrospective study the sexual activity, comfort of the experience, quality of sexual life (QoSL) during 3 periods were analyzed: before surgery, a month after and half a year after surgery. Analysis of demographic characteristics, comorbidities, previous surgeries, toumor characteristics and adjuvant therapy as was performed. Results. Most patients (64/100, 64%) expressed that LAR operation has strongly affected their QoSL, 32 patients reported the mild decrease in QoSL, while only 4 patients stated that did not experience any changes in QoSL. QoSL was assessed in 3 different periods of time: before the operation, 1 month after and 6 months after the operation (22,6±3.7 vs. 11.3±7,9 vs. 17,0±6.3; p<0.0001 respectively). The decreased QoSL one and six months after the surgery were significantly lower in patients with diagnosed hypertension and higher BMI (p=0.0283). Conclusions. Sexual disorders after LAR for rectal cancer are often underestimated and it is very important to be aware of them. In our study, it was determined that male sex, higher BMI and hypertension are related to impair of sexual dysfunction after LAR. We observed that the most severe complaints related to sexual activity occur one month after the procedure, after 6 months in most of the patients' sexual disorders were decreased approaching the initial state.
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Impact of spinal injury with neurological consequences on sexual function: Sexual dysfunctions in women

63%
Tederko P., Krasuski M., Kiwerski J.
Medical Rehabilitation
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2007
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vol. 11(4)
32-35
EN
Patophysiological background of sexual dysfunctions in women after spine injury with neurological consequePatophysiological background of sexual dysfunctions in women after spine injury with neurological consequences (SINC) is a difficult object of scientific investigations and is not as accurately described as sexual impairment in men after SINC. In particular, systematic reports on pregnancy and its complications in women after SINC are lacking. Aim of the study: Presentation of backgrounds and specificity of sexual disorders, dysfunctions of partner relationships and contraception in women after SINC.Method: Literature review, authors’ clinical experience.Results and conclusions: Persons with sexual dysfunction following SINC should be subjected to psychological evaluation and specified sexual education. These specific interventions should be introduced at the appropriate time and take into account functional progress made during rehabilitation and the level of patients’ acceptance of disability. Partner’s involvement is crucial for effective psychotherapy of persons after SINC. A possibility to take the advantage of experience of other persons with a similar disorder is of particular value during the therapy. There is a positve correlation between the ability to experience sexual satisfaction and quality of social adaptation after SINC. The form, acceptance and efficiency of sexual education in persons after SINC are affected by cultural conditions.nces (SINC) is a difficult object of scientific investigations and is not as accurately described as sexual impairment in men after SINC. In particular, systematic reports on pregnancy and its complications in women after SINC are lacking. Aim of the study: Presentation of backgrounds and specificity of sexual disorders, dysfunctions of partner relationships and contraception in women after SINC.Method: Literature review, authors’ clinical experience.Results and conclusions: Persons with sexual dysfunction following SINC should be subjected to psychological evaluation and specified sexual education. These specific interventions should be introduced at the appropriate time and take into account functional progress made during rehabilitation and the level of patients’ acceptance of disability. Partner’s involvement is crucial for effective psychotherapy of persons after SINC. A possibility to take the advantage of experience of other persons with a similar disorder is of particular value during the therapy. There is a positve correlation between the ability to experience sexual satisfaction and quality of social adaptation after SINC. The form, acceptance and efficiency of sexual education in persons after SINC are affected by cultural conditions.
3
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Dyspareunia i bolesne miesiączki u kobiet z endometriozą – obserwacje kliniczne dotyczące zastosowania dienogestu

63%
Jarząbek-Bielecka G., Radomski D., Mizgier M., Wilczak M., Durda M., Kaczmarek M., Pawlaczyk M., Kędzia W., Pisarska-Krawczyk M.
Current Gynecologic Oncology
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2014
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vol. 12
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issue 4
271-277
EN
Introduction: Dyspareunia is defined as tenderness experienced during sexual intercourse without coexisting shrinkage of the vulva or vagina. Dyspareunia is a common sexual disorder in women and can be caused by endometriosis. Dienogest is an important medicine in the treatment of endometriosis. This study assesses the influence of the type of endometriosis (peritoneal vs. endometrioid cysts) on the prevalence of dyspareunia. Material: The examined group consisted of 28 women with endometrioid ovarian (chocolate) cysts without scattered foci of endometriosis, and 33 patients with peritoneal endometriosis. The control group included 60 women without gynecologic problems. Results: In women with endometriosis, dyspareunia was observed four times as frequently as in healthy women. Moreover, it was five times more frequent in women with peritoneal foci of endometriosis than in patients with endometrioid cysts. Conclusion: A diagnosis of dyspareunia should lead to evaluation for peritoneal endometriosis as a possible cause, given the significant relationship between these conditions. The association between peritoneal endometriosis and dyspareunia suggests that pain upon intercourse could stem from inflammatory mediators or adhesions connected with peritoneal endometriosis.
PL
Wstęp: Dyspareunię definiuje się jako odczuwanie bólu podczas stosunku płciowego bez współistniejącego obkurczenia sromu i pochwy. To powszechna dysfunkcja seksualna u kobiet, którą może powodować endometrioza. Bardzo ważną substancją stosowaną w leczeniu endometriozy jest dienogest. Celem niniejszej pracy była ocena wpływu postaci endometriozy (otrzewnowa vs torbiele endometrioidalne) na częstość występowania dyspareunii. Materiał: Do grupy badanej włączono 28 pacjentek z torbielami endometrioidalnymi (czekoladowymi) jajników bez rozsianych ognisk gruczolistości i 33 – z endometriozą otrzewnową. Grupę kontrolną stanowiło 60 kobiet bez rozpoznanych chorób ginekologicznych. Wyniki: U badanych z endometriozą dyspareunię obserwowano czterokrotnie częściej niż w grupie kontrolnej. U pacjentek z endometriozą otrzewnową dyspareunia występowała pięć razy częściej niż u tych z torbielami endometrioidalnymi. Wnioski: Rozpoznanie dyspareunii powinno prowadzić do oceny pod kątem obecności endometriozy otrzewnowej jako prawdopodobnej przyczyny – ze względu na obserwowane korelacje między tymi schorzeniami. Związek endometriozy otrzewnowej i dyspareunii sugeruje, iż bolesność w trakcie stosunku płciowego może wynikać z działania mediatorów zapalnych lub zrostów związanych z endometriozą.
4
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Impact of spinal injury with neurological consequences on sexual function: Sexual dysfunctions in men

63%
Tederko P., Krasuski M., Kiwerski J.
Medical Rehabilitation
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2007
|
vol. 11(4)
27-31
EN
Sexual impairment and decreased fertility constitute a part of a complex dysfunction typical for men with spinal injury with neurological consequences (SINC). Despite the progress in medical sciences and quality of care provided for disabled persons, the problem is often neglected by medical professionals and caregivers.Aim of the study: Presentation of patophysiological background and specificity of sexual dysfunction typical for men following SINC. Review of contemporary treatment modalities designed for erectile dysfunction and infertility in men after SINC.Method: Literature review, authors’ clinical experience.Results and conclusions: Specific neurological deficit with overlapping adaptation problems and depression account for erectile dysfunction in men after SINC. There is a wide range of efficient therapies addressed to patients suffering from erectile disturbances resulting from SINC. Selection of a proper therapy depends on location (level) of the lesion of a neural structure, type of deficit, functional status, presence of symptoms of autonomic dysreflexia, concomitant diseases and patient’s individual preferences. Patient’s awareness of the disability and positive attitude towards acceptance of alternative forms of sexual expressions are crucial for the therapeutic success. Ejaculation dysfunction and infertility are common among men after SINC. Application of contemporary methods of assisted reproduction may be efficient in about half of male population with SINC.
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