Methods
Patients meeting appropriate eligibility criteria were recruited for the present study. The surgical procedures are shown
in the video. The genitourinary function was evaluated on the basis of validated questionnaires including International Prostate
Symptom Score (IPSS), International Index of Erectile Function (IIEF), and Female Sexual Function Index (FSFI).
Results
A total of 112 patients (tumor, node, metastasis system stage I, n = 8; stage II, n = 54; stage III, n = 50; male, n = 58;
female, n = 54; age [mean ± standard deviation], 55.8 ± 6.4 years) with good baseline genitourinary function were operated
on with the intent of total preservation of pelvic autonomic nerves and curative resection of sigmoid colon cancer. The patients
were prospectively followed (median time of follow-up, 18 months; range, 6–30 months). In patients with a successful nerve-preserving
surgery (96.4%, n = 108), 104 patients completed the evaluation of urinary function. The median duration for indwelling urine
Foley catheter was 3.0 days (range, 1.0–7.0 days). The voiding function after removal of the urine Foley catheter was good
(IPSS, 0–7) in 98 (94.2%) patients, fair (IPSS, 8–14) in 5 (4.8%), and poor (IPSS, 15–35) in 1 (1.0%). Before and after nerve-preserving
surgery, there were no significant changes of IPSS scores (3.20 ± 1.72 vs. 3.68 ± 2.82, P = .075, paired t-test) in the present patient series. Forty-four male patients completed the postoperative evaluation of sexual function, and
ejaculation was ranked as good in 40 (90.9%), fair (decrease in ejaculatory amounts) in 3 (6.8%), and poor (retrograde ejaculation,
failure of ejaculation) in 1 (2.3%), whereas the potency was good (IIEF, 60–75) in 41 (93.2%), fair (IIEF, 44–59) in 2 (4.5%),
and poor (IIEF, 5–43) in 1 (2.3%). Moreover, before and after a successful nerve-preserving operation, there were no significant
changes of IIEF scores (72.4 ± 4.6 vs. 70.3 ± 8.4, P = .082, paired t-test). For female patients (n = 42), the postoperative sexual function was ranked as good (FSFI score, 76–95) in 36 (85.7%),
fair (FSFI, 58–75) in 4 (9.5%), and poor (FSFI, 4–57) in 2 (4.8%). Furthermore, there were no significant changes of FSFI
scores (89.0 ± 9.2 vs. 85.4 ± 16.4, P = .122, paired t-test) before and after successful nerve-preserving surgery.