Sexual Function, Incontinence, and Wellbeing in Women after Rectal Cancer—A Review of the Evidence

Authors

  • Mary Panjari PhD,

    Corresponding author
    1. Women's Health Research Program, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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  • Robin J. Bell MBBS, PhD, MPH, FAFPHM,

    1. Women's Health Research Program, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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  • Susan Burney PhD, FAPS,

    1. School of Psychology and Psychiatry, Monash University, Melbourne, Australia
    2. Colorectal Unit, Cabrini Hospital, Melbourne, Australia
    3. Cabrini Monash Psycho-oncology Research Unit, Melbourne, Australia
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  • Stephen Bell MBBS, FRACS,

    1. Colorectal Unit, Cabrini Hospital, Melbourne, Australia
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  • Paul J. McMurrick MBBS (Hons), FRACS,

    1. Cabrini Monash University Department of Surgery, Melbourne, Australia
    2. Colorectal Unit, Cabrini Hospital, Melbourne, Australia
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  • Susan R. Davis MBBS, FRACP, PhD

    1. Women's Health Research Program, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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  • Funding:

  • Dr Panjari is a recipient of a National Health and Medical Research Council Early Career Fellowship 1034977.

  • This Research Project was supported by the Victorian Government through a Victorian Cancer Agency Research Fellowship to Professor Robin Bell.

  • This work was supported by the National Health and Medical Research Council of Australia through a fellowship to Professor Susan Davis (fellowship number 490938).

Mary Panjari, PhD, Women's Health Research Program, School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Level 6 Alfred Centre, 99 Commercial Road, Melbourne, Vic. 3004, Australia. Tel: 613 9903 0829; Fax: 613 9903 0828; E-mail: mary.panjari@monash.edu

ABSTRACT

Introduction.  Colorectal cancer (CRC) is the second most common cancer. One-third of these cancers occur in the rectum. Treatment of rectal cancer involves surgery with/without radiotherapy and chemotherapy. Surgery is undertaken to prevent damage to the nerves controlling bladder, bowel, and sexual organs, whether this translates into preservation of urinary and fecal continence and sexual function and, ultimately, quality of life (QoL) is not known.

Aim.  The aim of this review was to summarize the literature regarding the impact of treatment for rectal cancer on bladder and bowel continence, sexual function and QoL in women.

Main Outcome Measures.  A comprehensive review of the current literature on sexual function, incontinence and wellbeing in women after treatment for rectal cancer highlighting prevalence rates, trial design, and patient population.

Methods.  We conducted a systematic search of the literature using A systematic search of the literature using Medline (Ovid, 1946–present) and PubMed (1966–2011) for English-language studies that included the following search terms: “colorectal cancer,” or “rectal cancer,” or “rectal neoplasm,” and “sexual function,” or “sexual dysfunction,” or “wellbeing,” or “QoL,” or “urinary or fecal incontinence.”

Results.  Although around 1/3 of women aged 50 to 70 years report lack of sexual desire, sexual function problems after treatment for rectal cancer are in the order of 60% among women. QoL improves with length of survival. Urinary and fecal incontinence are ongoing concerns for many women after treatment with rates up to 60%.

Conclusion.  There is a gap in our knowledge of the effects of rectal cancer and its treatment on urinary and fecal continence, sexual function and QoL in women. There is a need for studies of sufficient size and duration to gain a better understanding of the disease and its management and the long-term effects on these parameters. This information is needed to develop preventative health care plans for women treated for rectal cancer that target those most at risk for these adverse outcomes. Panjari M, Bell RJ, Burney S, Bell S, McMurrick PJ, and Davis SR. Sexual function, incontinence, and wellbeing in women after rectal cancer—A review of the evidence. J Sex Med 2012;9:2749–2758.

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