Background: Sphincter saving rectal cancer management affects anorectal function. This study evaluated persisting anorectal dysfunction and its impact on patients well-being.
Methods: Seventy-nine patients with a follow-up of 12 - 37 months (median 22 months) and seventy-nine age- and sex-matched control subjects completed questionnaires.
Results: Median number of daytime bowel movements was 3 in patients and 1 in controls (p<.0001). Nighttime defecation occurred in 53% of patients. The median Vaizey score was 8 in patients and 4 in controls (p<.0001). Urgency without incontinence was reported by 47% of patients and 49% of controls (p=0.873), soiling by 28% of patients and 3% in controls (p<0.0001), incontinence for flatus by 73% of patients and 49% of controls (p=0.0019), incontinence for solid stools by 16% of patients and 4% of controls (p=0.0153). Incontinence for liquid stools occurred in 17 of 20 patients and 1 of 5 controls who had liquid stools (p=0.0123). Incontinence for gas, liquid or solid sto ols occurred once or more weekly in 47%, 19% and 6% of patients respectively. Evacuation difficulties were reported by 98% of patients, but also by 77% in controls. Neoadjuvant radio(chemo)therapy adversely affected defecation frequency and continence. Incontinence caused severe discomfort in 50% of patients, severe fear in 40%, and severe embarrassment in 48%.
Conclusion: Anorectal dysfunction is a frequent problem with an impact on patients well-being after rectal cancer management. Organizing individually adapted care could improve function in several of them.