Assessment of XXXX after total mesorectal excision with pelvic autonomic nerve preservation in males with @entity5 .

@entity5 @entity1 @entity458 @entity250
PURPOSE: Total mesorectal excision with pelvic autonomic nerve preservation has been reported to be an optimal surgery for @entity5 . It minimizes local recurrence and @entity250 . The aim of this study was to assess the safety of total mesorectal excision with pelvic autonomic nerve preservation in terms of voiding and sexual function in males with @entity5 . METHODS: We performed urine flowmetry using Urodyn and a standard questionnaire using the International Index of Erectile Function and the International Prostate Symptom Score before and after surgery in 68 males with @entity5 . RESULTS: Significant differences in mean maximal urinary flow rate and voided volume were seen before and after surgery (18.9 +/- 5.7 13.7 +/- 7.0, 240 +/- 91.9 143 +/- 78; < 0.05, < 0.05, respectively), but no differences in residual volume before and after surgery were apparent (4.4 +/- 2.6 8.1 +/- 4.4; > 0.05). The total International Prostate Symptom Score was increased after surgery from 6.2 +/- 5.8 to 9.8 +/- 5.9 ( < 0.05). There were no changes of score for one of each of seven International Prostate Symptom Score items in 49 @entity1 (73.5 percent) to 61 @entity1 (89.7 percent). Five International Index of Erectile Function domain scores (erectile function, intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction) were significantly decreased after surgery (18.2 +/- 9.3 13.5 +/- 9, 8.4 +/- 4.2 4.4 +/- 2.9, 5.8 +/- 2.9 4.4 +/- 2.9, 6.1 +/- 2.4 4.8 +/- 2, 6.1 +/- 2.2 4.5 +/- 2.3, respectively; < 0.05). Erection was possible in 55 @entity1 (80.9 percent); penetration ability was possible in 51 @entity1 (75 percent). Complete inability for erection and intercourse was observed in three @entity1 (5.5 percent). Retrograde ejaculation was noted in 9 @entity1 (13.2 percent). International Index of Erectile Function domains such as sexual desire and overall satisfaction were greatly decreased in 39 @entity1 (57.4 percent) and 43 @entity1 (63.2 percent), respectively. Multiple regression analysis of factors affecting postoperative @entity250 showed that age older than 60 years (sexual desire, P = 0.019), within six months (erectile function, P = 0.04; intercourse satisfaction, P = 0.011; orgasmic function, P = 0.03), lower @entity5 (erectile function, P = 0.02; intercourse satisfaction, P = 0.036; orgasmic function, P = 0.027) were significant factors adversely affecting sexual function. CONCLUSION: Total mesorectal excision with pelvic autonomic nerve preservation showed relative safety in preserving @entity458 . The International Prostate Symptom Score and International Index of Erectile Function questionnaires were useful in assessing urinary and sexual function.
