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A recent study published in a German medical journal has found that patients who have colorectal surgery have diminished sexual function and quality of life. Men were affected more frequently than women and had a greater degree of distress about their sex lives than women did. The younger the patient was, the more they reported having problems with intimacy following surgery. A larger size wound was also associated with increased sexual difficulties.
FIve hundred and ninteen patients had surgery for rectal cancer between January 1997 and January 2003 and were given questionnaires before surgery, on discharge from hospital and at varying intervals after surgery. One hundred and five patients died from cancer during the follow up period, although for 50 of them, completed questionnaires were available.
Questions asked on sexuality were, “has the operation resulted in an impairment of your sexuality? How much does this disturb you?”
Both males and females experienced impaired sexuality, but this was particularly marked with men and got progressively worse with time. Emotional distress was also significantly worse after 24 months, compared with how it had been three months post surgery. Sexual impairment was caused by negative effects on anal sphincter function and pelvic function and by erectile dysfunction. Men are thought to struggle emotionally with sexual problems more than women because of their higher sex drive.
The results are underestimated because many patients refuse to discuss sexuality and think questions about erectile dysfunction are too personal, so the problem may be more widespread and significant than the medical profession realize.
Colorectal cancer is one of the most common cancers and in Germany where the study was conducted there are 70,000 new cases each year and 30,000 deaths, so the issue of quality of life and sexual satisfaction should be taken into consideration more seriously. Health is not just an absence of symptoms, it is having full emotional and social fulfilment too.
The World Health Organization classifies health as, "A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." When a patient is considering colorectal surgery, they should be made fully aware of the potential sexual side-effects in order to give fully informed consent. Psycho-sexual counseling should be made available to all colorectal cancer patients.
Source: Dtsch Arztebl Int 2010; 107(8): 123-30.
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting, in addition to running a charity for people damaged by vaccines or medical mistakes.
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