Functional Complications After Colon and Rectal Surgery
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Although colorectal surgeons are adept at discussing potential complications of colorectal surgery, they may not be as thorough in the discussion of functional outcomes. Bowel dysfunction after low colorectal or coloanal anastomoses is extremely common and underappreciated. Low anterior resection syndrome can occur in up to 80% of patients, including symptoms of urgency, stool fragmentation, incontinence, and frequency. Sexual dysfunction, urinary symptoms, and stool leakage (causing difficult hygiene and perianal skin irritation) can also cause a significant decrease in quality of life. The etiology of these functional outcomes includes damage to the pelvic nerves or sphincter complex, resection of all or a portion of the rectum, as well as disturbances in motility and radiotherapy damage. Treatment includes medical and dietary measures including utilization of colonic irrigation and improved perianal cleaning and bowel habits as well as pelvic floor physical therapy. Novel treatments for functional problems after colorectal surgery are currently being investigated.