Rectal cancer after surgery voiding function and sexual dysfunction is a common complication in order to improve the quality of life after surgery the patient should be taken seriously enough, this article will focus on postoperative sexual dysfunction.
Now generally believed that its occurrence is mainly due to damage of the control urinary and sexual organs of the pelvic nerve caused by the clinical degree of sexual dysfunction are often associated with pelvic lymph node dissection is proportional to the scope.
Pelvic nerve with sexual function are closely related to the presacral sympathetic nerves and parasympathetic part of the pelvic splanchnic nerves, which are involved in pelvic plexus constitute a major component of issuing branch to the rectum, bladder, prostate, spermatic cord, seminal vesicles, uterus and vagina.
Sexual dysfunction after surgery is currently mostly male ejaculation and erectile dysfunction is characterized by. Ejaculation is the pre-sacral nerve under the action of the vas deferens a sudden contraction of smooth muscle, etc., first semen from the vas deferens, seminal vesicle, prostate, after driving into the urethra, and then in the pudendal nerve under the action of the corpus cavernosum in vitro muscle contraction in the completion of injection, so the presacral nerve also known as ejaculation nerve. In the pelvic splanchnic ejaculation erection under the influence of the small arteries within the penis, congestive expansion of cavernous blood vessels within the penis increases the volume of the formation, so the pelvic splanchnic nerves also known as erectile nerves.
When the pre-sacral nerve, pelvic splanchnic nerve and pelvic plexus injury suffered varying degrees of clinical severity does not appear it would be - ejaculation and erectile dysfunction. Clinical experience suggest that if the surgery can pre-sacral nerve and pelvic splanchnic nerves from damage, will reduce or avoid the occurrence of sexual dysfunction. Pre-sacral nerve plexus from the lower abdominal aorta and the lumbar sympathetic trunk section 3,4 of the lumbar splanchnic nerves involved in separation of the composition across the aortic bifurcation of the nerve plexus around the lower abdomen was divided into nerve, and along the internal iliac artery downstream from the After the top of the pelvis into the pelvic plexus, and thus surgical ligation and transection of the inferior mesenteric artery, vein, free sigmoid colon mesentery, the stripping operation should be carried out between the peritoneum and the fascia. Usually part of the nerve branches of the right and left lower than the aortic bifurcation, as long as careful dissection and careful hemostasis is not difficult to distinguish.
Sexual dysfunction after surgery to prevent the key is to remove the scope and the level of stripping, surgical resection of the rectum as long as the bear near the rectum, did not damage presacral nerve, pelvic splanchnic nerves and pelvic plexus, post-operative urinary and sexual dysfunction, the incidence of extreme low. However, the rectal cavity often infiltration, stripping, and excision of a small radical resection would be difficult to achieve the purpose, should be placed on treatment of radical resection always the most important position.