Sexual and Urinary Disorders after Treatment of Rectal Cancer by Radiotherapy and Surgery at the Dantec University Hospital of Dakar

Abstract

We performed a descriptive retrospective study of sexual and urinary disorders after treatment of rectal cancer by radiotherapy and/or surgery at the Dantec University Hospital in Dakar from 2008 to 2015. The objective of the study was to evaluate these sexual and urinary complications and the factors influencing it. We have collected 50 patients. The average age of is 55.7 years with a sex ratio of 0.78. The dominant clinical signs are rectorrhagia (66.0%). Endoscopy (94.0% of patients) showed an ulcerative-budding appearance in 84.0% of cases. The preferred location was the lower rectum 66.0%). The predominant histologic type is adenocarcinoma lieberkunien (82.0%). Computed tomography is performed in 78% of cases and MRI in 30%. Stage III accounts for 70.0% of cases. Thirty-two patients (64.0%) were treated with conventional 2-beam 2D radiation therapy with or without chemotherapy. The total dose of 46 Gy in 23 sessions was the most used, found in 22 patients; 30 Gy in 10 sessions in 9 cases. And 16 Gy in 10 sessions, found in 1 case. Surgery performed was abdominoperineal amputation (58.0%) and conservative surgery (42.0%). We note a complete response in 28.0% of patients; 8.0%, an increase of 16.0% and a stabilization of 4.0%. The sexual disorders are more important after radiotherapy compared to non-irradiated patients: 31.3% vs 5.6% (p = 0.035). We observe respectively that 2%, 6% and 8% of our patients had urinary disorders in the form of acute retention, urinary incontinence, and urinary burning. Patient follow-up time was between 0 and 42.83 months with an estimated average of 34.9 ± 3.37. The evolution is marked at 6 months by a persistence of sexual disorders in 63.8% of cases and urinary dysfunction in 4% of cases.