Abstract: ObjectiveTo evaluate the effects of total mesorectal excision( TME) with pelvic autonomic nerve preservation( PANP) in the treatment of rectal cancer on the male urinary and sexual function and local recurrence rate. Methods: Seventy-one male patients with middle or low rectal cancer were randomly divided into treatment group( 36 cases) and control group( 35 cases) .The treatment group and control group were treated with PANP-TME and traditional radical resection of rectal cancer， respectively.The incidences of male urinary disfunction， sexual dysfunction and tumor local recurrence in two groups were compared.Results: The incidences of urinary dysfunction， erectile dysfunction，defective ejaculation and tumor local recurrence in treatment group and control group were 16.7% ＆54.3%， 30.6% ＆ 65.7%， 36.1%＆ 71.4% and 8.3% ＆ 11.4%， respectively.The differences of the incidence of urinary and sexual dysfunction in two groups had statistical significance( P 0.01) ， the difference of tumor local recurrence rate in two groups had no statistical significance ( P 0.05 ) . Conclusions: TME with PANP can effectively reduce the incidences of postoperative urinary dysfunction and sexual dysfunction，but it does not increase postoperative local recurence rate.