BACKGROUND: The introduction of total mesorectal excision (TME) has been shown to improve local recurrence rates in @entity5 . The present study investigated the impact of this more extensive and radical procedure with regard to autonomic pelvic nerve function. METHODS: @entity1 with resected primary @entity5 were interviewed by means of a questionnaire asking about preoperative and postoperative urinary bladder and genital function. The results in @entity1 after @entity5 surgery without TME (group 1; n = 29) were compared with those obtained after introduction of the TME technique (group 2; n = 31). @entity1 in group 2 were older and had a lower level of @entity254 than @entity1 in group 1. Other @entity1 , treatment and @entity5 characteristics were comparable between the groups. RESULTS: : Newly acquired and permanent symptoms of @entity1494 after rectal excision were present as follows (group 1 versus group 2): difficulty in bladder emptying 7 versus 19 per cent; sensation of incomplete bladder voiding 17 versus 17 per cent; urgency 17 versus 14 per cent; incontinence 10 versus 3 per cent; dysuria 7 versus 7 per cent; and dribbling 14 versus 8 per cent. Male @entity1 stated the following sexual functions before operation/after operation in group 1 versus group 2: interest in sex 80 per cent/40 per cent versus 63 per cent/37 per cent; sexually active 67 per cent/7 per cent versus 53 per cent/22 per cent; impotence 75 per cent/6 per cent versus 58 per cent/26 per cent; ability to have intercourse 75 per cent/13 per cent versus 67 per cent/29 per cent; ability to achieve orgasm 88 per cent/13 per cent versus 76 per cent/47 per cent; and orgasm with ejaculation 88 per cent/9 per cent versus 76 per cent/53 per cent. CONCLUSION: While both conventional @entity5 surgery and TME result in similarly favourable postoperative bladder function, both techniques decrease sexual function. However, TME offers a significant advantage with regard to preservation of postoperative sexual function in @entity1 and constitutes a true advance in @entity5 surgery compared with conventional techniques.

Total mesorectal excision preserves male genital function compared with conventional XXXX surgery.

@entity5 :: ('MESH:D009369', 'Disease') :: ['rectal cancer', 'tumour'] @entity1 :: ('9606', 'Species') :: ['men', 'Patients', 'patients', 'patient'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity1494 :: ('MESH:D001745', 'Disease') :: ['bladder dysfunction']
@entity5 :: (MESH:D009369,Disease) :: ['rectal cancer']
