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What is the benefit of preoperative sperm preservation for patients who undergo restorative proctocolectomy for benign diseases?

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: In patients with benign colorectal diseases undergoing a restorative proctocolectomy with an ileal pouch-anal anastomosis, semen cryopreservation seems rational to enable the possibility of procreation in case surgery leads to sexual disorders or impotence. The aim of this study was to determine the preoperative and postoperative semen quality in patients undergoing ileal pouch-anal anastomosis. In addition, the study sought to determine the incidence of surgery-induced sexual dysfunction to evaluate the economic efficiency of semen cryopreservation as compared with alternatives such as microsurgical epididymal sperm aspiration. METHODS: Preoperative and postoperative semen analyses were offered to 97 patients with ileal pouch-anal anastomosis with benign colorectal diseases since 1989. The direct costs of the semen cryopreservation program were determined and compared with those of alternatives. RESULTS: In 34 of 40 consecutive patients with ileal pouch-anal anastomosis who made use of preoperative semen preservation, normal sperm concentrations, motility, and morphology were found. Mean semen characteristics of all 23 patients who returned for postoperative analysis were not different from preoperative values, but they were for total sperm number. Two patients developed temporary retrograde ejaculation postoperatively. None of the preserved semen samples was used, thus semen cryopreservation benefited none of these patients. The total costs of semen cryopreservation are between 2.2 and 5 times higher than the costs for one microsurgical epididymal sperm aspiration procedure. CONCLUSIONS: Preoperative semen cryopreservation in patients undergoing ileal pouch-anal anastomosis because of benign colorectal diseases is quite feasible. However, most likely because of improved surgical techniques and the increasing number of effective alternatives, preoperative semen cryopreservation in patients with ileal pouch-anal anastomosis is no longer cost effective.

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References

  1. Fazio VW, Ziv Y, Church JM,et al. Ileal pouch-anal anastomoses complications and function in 1005 patients. Ann Surg 1995;222:120–7.

    Google Scholar 

  2. Nyam DC, Brillant PT, Dozois RR, Kelly KA, Pemberton JH, Wolff BG. Ileal pouch-anal canal anastomosis for familial adenomatous polyposis: early and late results. Ann Surg 1997;226:514–21.

    Google Scholar 

  3. Pemberton JH, Phillips SF, Ready RR, Zinsmeister AR, Beahrs OH. Quality of life after Brooke ileostomy and ileal pouch-anal anastomosis. Comparison of performance status. Ann Surg 1989;209:620–8.

    Google Scholar 

  4. Kohler LW, Pemberton JH, Zinsmeister AR, Kelly KA. Quality of life after proctocolectomy: a comparison of Brooke ileostomy, Kock pouch, and ileal pouch-anal anastomosis. Gastroenterology 1991;101:679–84.

    Google Scholar 

  5. World Health Organization (WHO). Laboratory manual for the examination of human semen and semencervical mucus interaction. 2nd ed. Cambridge: Cambridge University Press, 1987.

    Google Scholar 

  6. Kolettis PN, Thomas AJ Jr. Vasoepididymostomy for vasectomy reversal: a critical assessment in the era of intracytoplasmic sperm injection. J Urol 1997;158:467–70.

    Google Scholar 

  7. Donovan JF Jr, DiBaise M, Sparks AE, Kessler J, Sandlow JL. Comparison of microscopic epididymal sperm aspiration and intracytoplasmic sperm injection/in-vitro fertilization with repeat microscopic reconstruction following vasectomy: is second attempt vas reversal worth the effort? Hum Reprod 1998;13:387–93.

    Google Scholar 

  8. Cook RJ, Sackett DL. The number needed to treat: a clinically useful measure of treatment effect. BMJ 1995;310:452–4.

    Google Scholar 

  9. Slors JF, Taat CW. Ileal pouches: technical aspects of the pouch-anal anastomosis. Ann Ital Chir 1994;65:455–8.

    Google Scholar 

  10. Slors JF, Ponson AE, Taat CW, Bosma A. Risk of residual rectal mucosa after proctocolectomy and ileal pouchanal reconstruction with the double-stapling technique: postoperative endoscopic follow-up study. Dis Colon Rectum 1995;38:207–10.

    Google Scholar 

  11. McCourtney JS, Finlay IG. Totally stapled restorative proctocolectomy. Br J Surg 1997;84:808–12.

    Google Scholar 

  12. Meagher AP, Farouk R, Dozois RR, Kelly KA, Pemberton JH. J ileal pouch-anal anastomosis for chronic ulcerative colitis: complications and long-term outcome in 1310 patients. Br J Surg 1998;85:800–3.

    Google Scholar 

  13. Walsh PC, Schlegel PN. Radical pelvic surgery with preservation of sexual function. Ann Surg 1988;208:391–400.

    Google Scholar 

  14. Damgaard B, Wettergren A, Kirkegaard P. Social and sexual function following ileal pouch-anal anastomosis. Dis Colon Rectum 1995;38:286–9.

    Google Scholar 

  15. Panis Y, Bonhomme N, Hautefeuille P, Valleur P. Ileal pouch-anal anastomosis with mesorectal excision for rectal cancer complicating familial adenomatous poly posis. Eur J Surg 1996;162:817–21.

    Google Scholar 

  16. Kartheuser AH, Parc R, Penna C,et al. Ileal pouch-anal anastomosis as the first choice operation in patients with familial adenomatous polyposis: a ten-year experience. Surgery 1996;119:615–23.

    Google Scholar 

  17. Ziv Y, Fazio VW, Church JM, Lavery IC, King TM, Ambrosetti P. Stapled ileal pouch anal anastomoses are safer than handsewn anastomoses in patients with ulcerative colitis. Am J Surg 1996;171:320–3.

    Google Scholar 

  18. Sagar PM, Pemberton JH. Ileo-anal pouch function and dysfunction. Dig Dis 1997;15:172–88.

    Google Scholar 

  19. Zelissen PM, van Hattum J, Poen H, Scholten P, Gerritse R, te Velde ER. Infleunce of salazosulphapyridine and 5-aminosalicylic acid on seminal qualities and male sex hormones. Scand J Gastroenterol 1988;23:1100–4.

    Google Scholar 

  20. Kjaergaard N, Christensen LA, Lauritsen JG, Rasmussen SN, Hansen SH. Effects of mesalazine substitution on salicylazosulfapyridine-induced seminal abnormalities in men with ulcerative colitis. Scand J Gastroenterol 1989;24:891–6.

    Google Scholar 

  21. Farthing MJ, Dawson AM. Impaired semen quality in Crohn's disease—drugs, ill health, or undernutrition? Scand J Gastroenterol 1983;18:57–60.

    Google Scholar 

  22. Lange D, Henning H, Schirren C. Andrologic study in immunosuppressive treatment of chronic aggressive hepatitis. Andrologia 1978;10:373–9.

    Google Scholar 

  23. Tournaye H, Camus M, Bollen N,et al. In vitro fertilization techniques with frozen-thawed sperm: a method for preserving the progenitive potential of Hodgkin patients. Fertil Steril 1991;55:443–5.

    Google Scholar 

  24. Sanger WG, Olson JH, Sherman JK. Semen cryobanking for men with cancer—criteria change. Fertil Steril 1992;58:1024–7.

    Google Scholar 

  25. Jimenez C, Grizard G, Pouly JL, Boucher D. Birth after combination of cryopreservation of sperm recovered from urine and intracytoplasmic sperm injection in a case of complete retrograde ejaculation. Fertil Steril 1997;68:542–4.

    Google Scholar 

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Authors and Affiliations

  1. the Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, the Netherlands

    Gouke J. Bonsel M.D., Ph.D.

  2. the Department of Center for Reproductive Medicine, Academic Medical Center, Amsterdam, the Netherlands

    Jan W. A. de Vries M.D.

  3. Department of Surgery, Academic Medical Center, G4-144, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands

    Peter van Duijvendijk M.D., Ph.D., J. Frederik M. Slors M.D., Ph.D., Carlo W. Taat M.D., Ph.D., Laura T. van Lochem M.Sc. & Huug Obertop M.D., Ph.D.

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  1. Peter van Duijvendijk M.D., Ph.D.
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  2. J. Frederik M. Slors M.D., Ph.D.
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  3. Carlo W. Taat M.D., Ph.D.
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  4. Laura T. van Lochem M.Sc.
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  5. Gouke J. Bonsel M.D., Ph.D.
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  6. Jan W. A. de Vries M.D.
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  7. Huug Obertop M.D., Ph.D.
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van Duijvendijk, P., Slors, J.F.M., Taat, C.W. et al. What is the benefit of preoperative sperm preservation for patients who undergo restorative proctocolectomy for benign diseases?. Dis Colon Rectum 43, 838–842 (2000). https://doi.org/10.1007/BF02238024

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  • DOI: https://doi.org/10.1007/BF02238024

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