Genito-Urinary Function after Lateral Node Dissection with Concomitant Pelvic Autonomic Nerve Preservation (PANP) for Rectal Cancer

Introduction: Lateral node dissection for advanced rectal cancer, in which perirectal tissues are widely removed and superior as well as lateral nodes are dissected has contributed to improve the local failure and survival. Nevertheless urinary and sexual dysfunction frequently occur after lateral node dissection because of the damage of the intrapelvic nerves.Study design: A total of 31 male patients underwent lateral node dissection, 15 patients were eligible for the technique while 16 patients did not receive (PANP). All the patients responded to standardized questionnaire regarding the current and preoperative urinary sexual function as well as follow-up examination six months after surgery.Results: Regarding the bladder function, 10 patients out of 15 (67%) who were offered (PANP) maintained good urinary control p 0.04, compared to 5 patients out of 16 (19%) in the group that was not submitted to (PANP).Regarding the sexual function, 9 patients out of 15 (60%) with (PANP) maintained satisfactory erection p 0.04, compared to 4 patients out of 16 (25%) who were not submitted to (PANP). Ejaculation was achieved in 2 patients out of 15 (13%) with (PANP), compared to 0% in the group without (PANP).Conclusion: Lateral node dissection with either partial or complete (PANP) combines the curative benefit of enhanced perirectal tissue excision with a minium of voiding and sexual dysfunction in the majority of advanced rectal cancer patients.