Sexual and reproductive health after surgical procedures - the importance of multidisciplinary collaboration.

INTRODUCTION

Sexual and reproductive health remains under-recognized in surgical care despite its decisive impact on quality of life and overall outcomes.

METHODS

Narrative synthesis of recent guidance (EAU 2025, AUA 2024, ISSM/ESSM, NCCN/ASCO) and clinical evidence on sexual and reproductive sequelae after colorectal, vascular, and spinal procedures.

KEY FINDINGS: Core mechanisms include autonomic denervation, vascular/hormonal factors, pain/scarring, and altered body image.  Pelvic oncologic surgeries (low anterior resection, radical prostatectomy/cystectomy) are high-risk procedures. High-value interventions include early penile rehabilitation (PDE5 inhibitors ± vacuum device) and fertility preservation (gamete cryopreservation), local estrogens/lubricants and pelvic-floor physiother-apy in women, and psychosexual support within coordinated multidisciplinary care across both sexes.

CONCLUSION

Embedding sexual and reproductive health into standard perioperative pathways (six-step algorithm: education, risk stratification, fertility preservation, nerve-sparing, discharge instructions, 6-12-week follow-up) is feasible in Czech practice and improves functional outcomes and patient satisfaction.