Sexual and bladder dysfunction after total mesorectal excision for benign diseases

Purpose: An evaluation was made of sexual and bladder dysfunction combined with quality of life (QoL) score after a proctocolectomy with total mesorec tal excision (TME) for benign diseases. Methods: An in-depth questionnaire was mailed to all patients (n = 94) who had undergone a proctocolectomy wit h TME followed by an ileal pouch-anal anastomosis (IPAA) in the period from 1989 through 1994. Seventy-six patients responded (81%) with a mean age of 34 +/- 10.6 years and a mean follow-up of 33 +/- 18.3 months. Results: Sex ual activity, satisfaction and libido were preserved better in males than i n females. Severe sexual dysfunction was found in two males (permanent retr ograde ejaculation) and in one female (complete vaginal dryness). No severe bladder dysfunction was found, although minor dysfunction, such as stress and urge incontinence, occurred frequently. QoL was significantly increased postsurgery. Moreover, no evident correlation was demonstrated between QoL and sexual and bladder dysfunction. Conclusion: A relatively low incidence of severe sexual and bladder disorders was found following proctocolectomy with TME and IPAA, whereas minor dysfunction was a relatively common findi ng. Nevertheless. a significant increase was found in postoperative QoL com pared to preoperative QoL.