Our Summary

This study looked at how a certain type of surgery for rectal cancer—transanal total mesorectal excision (taTME)—impacts patients’ ability to control their bowels, urinate, and have sexual intercourse. The researchers asked 100 patients to fill out questionnaires before their surgery, 3 to 4 months afterwards, and again 12 to 18 months after the surgery. They found that initially, patients had a harder time controlling their bowels and experienced changes to their defecation habits. However, these issues improved in most cases within a year after the surgery, although not quite back to normal. Urination wasn’t really affected by the surgery. Sexual function, however, did decline for both men and women and didn’t improve within the 18 months following the surgery. These findings help give doctors and patients a better idea of what to expect after this type of surgery.

FAQs

  1. What is the impact of transanal total mesorectal excision (taTME) on a patient’s ability to control their bowels and urination?
  2. How does transanal total mesorectal excision (taTME) affect a patient’s sexual function?
  3. Do the issues with bowel control and defecation habits improve over time after the surgery?

Doctor’s Tip

One helpful tip a doctor might give a patient undergoing a proctectomy is to be prepared for changes in bowel habits and potential challenges with sexual function following the surgery. It is important to communicate any concerns or difficulties with your healthcare provider so that they can provide appropriate support and guidance. Additionally, following a healthy diet, staying hydrated, and engaging in regular physical activity can help improve bowel function and overall recovery after the surgery.

Suitable For

Patients who are typically recommended for proctectomy include those with:

  • Rectal cancer
  • Ulcerative colitis
  • Familial adenomatous polyposis
  • Inflammatory bowel disease
  • Severe hemorrhoids
  • Rectal prolapse

It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if proctectomy is the best course of action for them.

Timeline

Before proctectomy:

  • Patient is diagnosed with rectal cancer and discusses treatment options with their healthcare provider
  • Patient undergoes pre-operative testing and preparation for surgery
  • Patient may receive chemotherapy and/or radiation therapy before surgery to shrink the tumor
  • Patient discusses potential side effects and risks of surgery with their healthcare provider

After proctectomy:

  • Patient undergoes surgery to remove the rectum and surrounding tissues
  • Patient may experience changes in bowel habits, difficulty controlling bowels, and urinary issues in the immediate post-operative period
  • Patient may need to use a temporary colostomy or ileostomy to allow the bowel to heal
  • Patient participates in follow-up appointments with their healthcare provider to monitor recovery and address any complications
  • Patient may experience improvements in bowel control and urinary function within the first year after surgery, although not fully back to normal
  • Patient may experience a decline in sexual function that does not improve within 18 months following surgery

Overall, the patient undergoes a significant physical and emotional journey before and after proctectomy, and may require ongoing support and care to manage the long-term effects of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a proctectomy?
  2. How will my bowel control be affected after the surgery?
  3. Will I experience changes in my defecation habits?
  4. How will my ability to urinate be impacted?
  5. What changes can I expect in my sexual function following the surgery?
  6. Will these changes improve over time?
  7. Are there any specific lifestyle modifications or treatments that can help manage any potential side effects of the surgery?
  8. How long is the recovery period after a proctectomy?
  9. What can I do to prepare for the surgery and optimize my recovery outcomes?
  10. Are there any support groups or resources available for patients undergoing a proctectomy surgery?

Reference

Authors: Donovan KF, Lee KC, Ricardo A, Berger N, Bonaccorso A, Alavi K, Zaghiyan K, Pigazzi A, Sands D, DeBeche-Adams T, Chadi SA, McLemore EC, Marks JH, Maykel JA, Shawki SF, Steele SR, Albert M, Whiteford MH, Cheng FY, Wexner SD, Sylla P. Journal: Ann Surg. 2024 Sep 1;280(3):363-373. doi: 10.1097/SLA.0000000000006374. Epub 2024 Jun 13. PMID: 38869440