International Journal of Colorectal Disease

, Volume 19, Issue 3, pp 215–218

Sexual function and continence after ileo pouch anal anastomosis: a comparison between a meta-analysis and a questionnaire survey

  • W. E. Hueting
  • H. G. Gooszen
  • C. J. H. M. van Laarhoven
Original Article

Abstract

Background and aims

Ileo pouch anal anastomosis (IPAA) is the standard restorative procedure for patients with ulcerative colitis and familial adenomatous polyposis, but its pros and cons have not been explored in depth. This study analyzed the long-term complications such as incontinence and sexual dysfunction after IPAA.

Patients and methods

Netherlands Society for Crohn’s disease and Ulcerative Colitis) A questionnaire on complications, sexual dysfunction, and continence was sent to all 137 members of the Netherlands Society for Crohn’s disease and Ulcerative Colitis who had IPAA; the questionnaire was returned by 111. Results of the questionnaire were compared with those of a meta-analysis on pooled incidences of complications after IPAA, as previously performed and reported.

Results

Pelvic sepsis was reported by 15.3% of respondents. The reported incidence of sexual dysfunction (19.8%), passive incontinence (23.4%), and soiling (39.3%) was significantly higher than that in the meta-analysis. Nevertheless, 90% of the population was satisfied with the results of the IPAA.

Conclusion

This study underlines that the operation itself, freeing patients of their disease, provides the major satisfaction and improvement of quality of life, even when patients have pouch-related complications such as sexual dysfunction and some degree of fecal incontinence.

Keywords

Ileo pouch anal anastomosis Incontinence Quality of life Questionnaire Ulcerative colitis 

Reference

  1. 1.
    Hueting WE, Buskens E, van der Tweel I, Gooszen HG, van Laarhoven CJHM (2001) Ileo pouch anal anastomosis: meta analysis on results and complications of 44 studies with 9435 patients. Colorectal Dis 3 [Suppl 1]:19Google Scholar
  2. 2.
    Laarhoven CJ van et al (1999) Ileoneorectal anastomosis: early clinical results of a restorative procedure for ulcerative colitis and familial adenomatous polyposis without formation of an ileoanal pouch. Ann Surg 230:750–757CrossRefPubMedGoogle Scholar
  3. 3.
    Andriesse GI et al (2001) Functional results and visceral perception after ileo neo-rectal anastomosis in patients: a pilot study. Gut 48:683–689CrossRefPubMedGoogle Scholar
  4. 4.
    Vaizey CJ, Carapeti E, Cahill JA, Kamm MA (1999) Prospective comparison of faecal incontinence grading systems. Gut 44:77–80PubMedGoogle Scholar
  5. 5.
    Metcalf AM, Dozois RR, Kelly KA (1986) Sexual function in women after proctocolectomy. Ann Surg 204:624–627PubMedGoogle Scholar
  6. 6.
    Damgaard B, Wettergren A, Kirkegaard P (1995) Social and sexual function following ileal pouch-anal anastomosis. Dis Colon Rectum 38:286–289PubMedGoogle Scholar
  7. 7.
    Pescatori M, Anastasio G, Bottini C, Mentasti A (1992) New grading and scoring for anal incontinence. Evaluation of 335 patients. Dis Colon Rectum 35:482–487Google Scholar
  8. 8.
    Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97PubMedGoogle Scholar
  9. 9.
    Steens J et al (2000) Limited influence of pouch function on quality of life after ileal pouch-anal anastomosis. Hepatogastroenterology 47:746–750PubMedGoogle Scholar
  10. 10.
    van Duijvendijk P et al (2000) Quality of life after total colectomy with ileorectal anastomosis or proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis. Br J Surg 87:590–596CrossRefPubMedGoogle Scholar
  11. 11.
    Dunker MS, Bemelman WA, Slors JF, van Duijvendijk P, Gouma DJ (2001) Functional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy: a comparative study. Dis Colon Rectum 44:1800–1807PubMedGoogle Scholar
  12. 12.
    Jimmo B, Hyman NH (1998) Is ileal pouch-anal anastomosis really the procedure of choice for patients with ulcerative colitis? Dis Colon Rectum 41:41–5PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • W. E. Hueting
    • 1
  • H. G. Gooszen
    • 1
  • C. J. H. M. van Laarhoven
    • 2
  1. 1.Department of SurgeryUniversity Medical CenterUtrechtThe Netherlands
  2. 2.Department of SurgerySt. Elisabeth HospitalTilburgThe Netherlands

Personalised recommendations