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Source created 2026-08-27 · updated 2026-08-27
colorectalASCRSsexual-dysfunctionquality-of-lifesurvivorship

ASCRS Ch63 - Sexual Function After Colorectal Surgery in Women

Chapter 63 of the ASCRS Textbook of Colon and Rectal Surgery, 4th edition (Keller DS, Ky-Miyasaka JA). PDF pages 1041-1052, book pages 1055-1066 (offset +14, unchanged from Ch62 — confirmed via the "© Springer Nature Switzerland AG 2022 1055" copyright line on the chapter's first PDF page). Ch63 ends on book page 1066, an even page, so per this wiki's offset-tracking rule the offset does not jump at the Ch63/Ch64 boundary — confirmed: Ch64 ("Male Genitourinary Dysfunction as a Consequence of Colorectal Surgery") begins at PDF page 1053/book page 1067, offset +14 unchanged (copyright line "© Springer Nature Switzerland AG 2022 1067").

Structure and content

The first of two paired chapters on sexual/genitourinary dysfunction after colorectal surgery (Ch64 covers male genitourinary dysfunction). Covers:

  • Scope of the problem: prevalence of postoperative sexual dysfunction in women (19-62% after colorectal cancer treatment), the QoLiRECT study, resection-extent and stoma effects, and IBD/pelvic-pouch-specific dysfunction rates (40-60%).
  • Etiology: a three-part framework — radiation (vaginal/vulvar radiosensitivity, the Dutch TME trial's 14-year follow-up data, Bregendahl et al., Thyø et al.), chemotherapy (ovarian estrogen loss), and surgery (detailed pelvic autonomic nerve anatomy — superior/inferior hypogastric plexus — and TME's nerve-preserving-dissection rationale).
  • Fertility impact: IPAA fertility reduction (44-82%), laparoscopic-vs-open fertility-outcome comparison, chemotherapy/radiation gonadal effects, fertility preservation options.
  • Defining the problem for treatment: the four-phase female sexual response model (desire, arousal, orgasm, resolution) and phase-specific treatment options (Table 63.2).
  • Measuring sexual dysfunction: the PFDC Working Group's 2020 recommendations — FSFI-9 and PISQ-IR as the two best-practice validated instruments.
  • Initiating the conversation, developing options for diverse patients, and multidisciplinary treatment teams: patient/provider communication barriers, cultural-competency considerations (age, ethnicity, sexual orientation, LGBTQ patients), and the recommended care team composition.

Wiki integration

New concept page Sexual Function After Colorectal Surgery created to hold this content — no prior wiki page covered female sexual dysfunction after colorectal surgery specifically (existing sexual mentions elsewhere in the wiki are incidental references within condition/procedure pages, e.g. quantified male erectile/ejaculatory dysfunction data on Total Mesorectal Excision (TME) & Sphincter-Sparing Resection and General Postoperative Complications). The new page is deliberately structured to also receive Ch64's male-specific content once that chapter is ingested, rather than creating two separate pages, since the two chapters share the same underlying nerve anatomy and much of the same conceptual framework (phases of dysfunction, multidisciplinary treatment). Light cross-reference additions anticipated on Total Mesorectal Excision (TME) & Sphincter-Sparing Resection and General Postoperative Complications.

Offset tracking

  • Chapter starts: PDF p.1041, book p.1055 (offset +14, confirmed via copyright line; unchanged from Ch62).
  • Chapter ends: book p.1066 (even page) → no jump expected or found at the Ch63/Ch64 boundary.
  • Ch64 confirmed starting at PDF p.1053/book p.1067, offset +14 unchanged (copyright line verified).