Incidence of genitourinary dysfunction following left‐sided colorectal cancer (CRC) resections
Published Date: 15th July 2020
Publication Authors: Javed M, Clark E, MacDonald S, Kalaiselvan R
Purpose
CRC patients are at an increased risk of developing genitourinary symptoms post‐operatively due to the pelvic dissection. Our primary aim was to evaluate the incidence of genitourinary dysfunction after CRC resections and secondary aim was to look at the documentation about the risk of genitourinary dysfunction in consent process.
Methods
Retrospective case series of all left‐sided CRC resections undertaken in a single centre between February 2015 and December 2017. Electronic records, clinic letters and consent forms were reviewed for data collection.
Results
Sample size was 167 with median age of 69 (range 27 ‐ 93) and the M:F of 1:0.68. 87.4% (n = 146) patients had a laparoscopic attempted procedure (conversion rate 4.1%). Median follow‐up was 32 months (range 19‐ 53). The incidence of sexual dysfunction was 7.8% (n = 13), incidence of urinary dysfunction was 8.4% (n = 14) and 1.8% (n = 3) complained of both groups of symptoms. Although all patients were reviewed in bowel school pre‐operatively and provided leaflets stating potential genitourinary complications, actual documentation of sexual and urinary dysfunction was 66.6% and 74 % respectively. Risk factors for genitourinary dysfunction were; rectal tumours (P = 0.029), conversion to open surgery (P = 0.033) and neoadjuvant radiotherapy (P = 0.001).
Conclusion
Incidence of genitourinary dysfunction after left‐sided CRC resections in this cohort was favourable compared to published literature. These findings suggest that pre‐operative discussion about genitourinary dysfunction and documentation in clinic letters as well as consent forms can be improved. We recommend procedure specific consent forms and designated consent clinics to further improve the quality of consent process.
Javed, MA; Reader, H; Clark, E; MacDonald, S; Kalaiselvan, R. (2020). Incidence of genitourinary dysfunction following left‐sided colorectal cancer (CRC) resections & relevant documentation in consent. Colorectal Disease. 22 (S1), 19-20