A comparative study on the sexual and urinary functions after transanal total mesorectal excision and low anterior resection for rectal cancer

Abstract

Background and Aims: Transanal total mesorectal excision (TATME) may address the problem of difficult dissection at the low rectum, but whether this translates into better outcome in terms of urogenital function is unknown. To compare the urogenital function of those who underwent TATME and robotic-assisted low anterior resection (RLAR). Methods: The urogenital function was assessed using the International Prostate Symptoms Score (IPSS) the International Index of Erectile Function (IIEF) questionnaires. Results: There were 23 and 41 male patients who underwent TATME and RLAR during the study period. For the TATME group, the IPSS score showed no significant difference compared to baseline at 3 and 6 months postoperative. There was significantly lower IIEF score at 3 months (P = 0.002), but recovered to baseline at 6 months (P = 0.142). For the RLAR group, the IPSS score was significantly higher (P = 0.018) at 3 months but recovered to baseline at 6 months (P = 0.413). The sexual function at 3 months (P = 0.499) and 6 months (P = 0.239) postoperative was comparable with the baseline. Conclusion: Both sexual and urinary functions returned to baseline at 6 months. Patients who underwent TATME had a faster recovery of urinary function, while those who underwent RLAR had an earlier return of erectile function.