Incidence of The Bowel, Bladder, and Sexual Dysfunction Following Surgery for Colorectal Malignancy

NCT ID: NCT04134104

Last Updated: 2023-11-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

38 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-12-31

Study Completion Date

2017-12-31

Brief Summary

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Colorectal cancer is the second most common cancer by the site in Europe and the third most common cancer in the USA with high morbidity and mortality. Survival after the treatment has improved over the past few decades as a result of early diagnosis, radiotherapy, and advances in surgical techniques such as abdominoperineal resection (APR), low anterior resection (LAR) and total mesorectal excision (TME). These innovative surgeries are the current standard treatment for the mid and the low rectal cancers which avoids the permanent colostomy. It is very difficult to find out the incidence of the bowel, bladder and sexual dysfunction of patients either because they are embarrassed or because they do not relate their symptoms to rectal cancer treatment. This article reports the incidence of the bowel, bladder and sexual dysfunction following surgery for rectal cancer from the National Academy of Medical Sciences, Bir Hospital, a tertiary level hospital.

Detailed Description

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It was a cross-sectional study at Bir Hospital and the duration of the study was from December 2014 to December 2017. Here, all the patients who underwent LAR and APR following neoadjuvant chemoradiotherapy were included. And, all the patients with recurrence after surgery, lost to follow up, benign disease, who did not undergo neoadjuvant chemoradiotherapy, and who underwent trans-anal excision were excluded from the study. In our study, the independent variable will be the type of surgery done for colorectal malignant disease. And the dependent variables will be the postoperative complications in the form of immediate and delayed complications. Immediate could be infectious or non-infectious complications and delayed (long term) complications could be bowel, bladder, and sexual dysfunction respectively.

Data collection was done using structured Performa that included all the demographic parameters, examination findings which included the data regarding neoadjuvant chemoradiotherapy and type of surgery (LAR and APR) were included. The laboratory parameters were also included. All the operative and post-operative details were included regarding bowel, bladder, and sexual dysfunction. And validated tools were used to calculate and analyze data.

LARS Score Questionnaire: The aim of this questionnaire was to assess the bowel function using a validated questionnaire.6 The LARS consists of five questions and can be used to generate an overall score that translates into no LARS (score 0-20), minor LARS (21-29), and major LARS (30-42) respectively.

IPSS Questionnaire: Assessment of bladder dysfunction was assessed by the validated questionnaire of International Prostatic Symptoms Score (IPSS) for bladder dysfunction.8 For the evaluation of preoperative and postoperative bladder function, a urologic history and residual urine volume measurements by ultrasound were done.

Sexual Function Evaluation: In the early period after surgery sexual function was measured using the validated questionnaire - the International Index of Female Sexual Function (IFSF) for females and the International Index of Erectile Function (IIEF) for males. These tools helped to assess the impact of a specific treatment modality by evaluating different sexual function domains. Our study group was small, so we did not classify the groups into mild, moderate, and severe dysfunction groups. We did the overall long term assessment of the patients who came for the follow-up. These specific questionnaires were asked and the assessment was done for the overall dysfunctions.

Ethics: The study was approved by the institutional ethical committee- "IRB of NAMS, Bir Hospital" and written consent was obtained from all of the patients.

Statistics: All the data were entered in SPSS version 16 and then statistical analysis was done. Type of surgery, the status of neoadjuvant chemoradiotherapy, and the postoperative outcomes were studied respectively. Correlation and logistic regression statistic tools were used. A comprehensive literature search published in English was done until 2019 using Hinari, PubMed, and Cochrane Library.

Conditions

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Bowel Dysfunction Bladder Dysfunction Sexual Dysfunction Colorectal Surgery

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Bowel, Bladder, and Sexual Dysfunction group

Out of 38 patients included for surgery 12 were excluded due to poor follow up and those patients who underwent upfront surgery. Only 26 patients were included in the study. There were 20 (76.9%) males and 6 (23.1%) females respectively. The mean age of the patient was 43.577yrs (26-75) and mean BMI was 20.78. The number of patients that underwent LAR was 24 (92.30%) and those who underwent APR were 2( 7.6%) after neoadjuvant chemoradiotherapy respectively.

Surgery for Colorectal malignant diseases either LAR or APR

Intervention Type PROCEDURE

Patients following LAR or APR were observed for the Bowel, Bladder, and Sexual Dysfunction

Interventions

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Surgery for Colorectal malignant diseases either LAR or APR

Patients following LAR or APR were observed for the Bowel, Bladder, and Sexual Dysfunction

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1\) All the patients who underwent LAR and APR following neoadjuvant chemoradiotherapy.

Exclusion Criteria

1. All the patients with recurrence after surgery,
2. Lost to follow up,
3. Benign disease,
4. Patients who did not undergo neoadjuvant chemoradiotherapy, and
5. Patients who underwent trans-anal excision.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Academy of Medical Sciences, Nepal

OTHER_GOV

Sponsor Role lead

Responsible Party

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Nabin Pokharel

Assistant Professor/ Senior Medical Officer

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nabin Pokharel, MCh

Role: PRINCIPAL_INVESTIGATOR

Bir Hospital

Gaurav Katwal, MS

Role: PRINCIPAL_INVESTIGATOR

Bir Hospital

Subodh K Adhikari, MS

Role: STUDY_DIRECTOR

Bir Hospital

References

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Related Links

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https://doi.org/10.1016/j.ejca.2018.07.005

Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018

http://dx.doi.org/10.1007/s00384-016-2549-y

A prospective study of sexual and urinary function before and after total mesorectal excision

Other Identifiers

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1145

Identifier Type: -

Identifier Source: org_study_id

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