Skip to main content

Advertisement

SpringerLink
Log in

Sexual Function, Body Image, and Quality of Life after Laparoscopic and Open Ileal Pouch-Anal Anastomosis

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

Abstract

Purpose

This study was designed to compare self-reported sexual function, body image, and quality of life outcomes among ulcerative colitis patients undergoing laparoscopic or open ileal pouch-anal anastomosis.

Methods

Between 1978 and 2004, 100 laparoscopic and 189 open operations were performed in patients who were identified from a previously published cohort. Patients were surveyed one year after operation to evaluate sexual function, body image, and quality of life.

Results

A total of 125 of 289 patients (43 percent) returned completed surveys. There were no significant differences in terms of demographics, complications, or long-term functional outcomes between those who completed the surveys and those who did not. There were no clinical differences in results between laparoscopic and open patients using the three survey instruments. Orgasmic function scores were lower in men who underwent laparoscopic ileal pouch-anal anastomosis (P < 0.05) compared with open ileal pouch-anal anastomosis. Overall, sexual function scores were equal to or better than normal values for men but were lower in women. Finally, overall body image and quality of life scores were above the means published for the United States.

Conclusions

After ileal pouch-anal anastomosis, men and women reported excellent body image and high cosmetic and quality of life scores regardless of operative approach. Female sexual function was more adversely affected after ileal pouch-anal anastomosis than was male sexual function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Chen HH, Wexner SD, Iroatulam AJ, et al. Laparoscopic colectomy compares favorably with colectomy by laparotomy for reduction of postoperative ileus. Dis Colon Rectum 2000;43:61–5.

    Article  PubMed  CAS  Google Scholar 

  2. Larson DW, Pemberton JH. Current concepts and controversies in surgery for IBD. Gastroenterology 2004;126:1611–9.

    Article  PubMed  Google Scholar 

  3. Young-Fadok TM, Radice E, Nelson H, Harmsen WS. Benefits of laparoscopic-assisted colectomy for colon polyps: a case-matched series. Mayo Clin Proc 2000;75:344–8.

    Article  PubMed  CAS  Google Scholar 

  4. Young-Fadok TM, HallLong K, McConnell EJ, Gomez RG, Cabanela RL. Advantages of laparoscopic resection for ileocolic Crohn’s disease. Improved outcomes and reduced costs. Surg Endosc 2001;15:450–4.

    Article  PubMed  CAS  Google Scholar 

  5. Bell RL, Seymour NE. Laparoscopic treatment of fulminant ulcerative colitis. Surg Endosc 2002;16:1778–82.

    Article  PubMed  CAS  Google Scholar 

  6. Dunker MS, Stiggelbout AM, van Hogezand RA, Ringers J, Griffioen G, Bemelman WA. Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 1998;12:1334–40.

    Article  PubMed  CAS  Google Scholar 

  7. Dunker MS, Bemelman WA, Slors JF, van Hogezand RA, Ringers J, Gouma DJ. Laparoscopic-assisted vs open colectomy for severe acute colitis in patients with inflammatory bowel disease (IBD): a retrospective study in 42 patients. Surg Endosc 2000;14:911–4.

    Article  PubMed  CAS  Google Scholar 

  8. Dunker MS, Bemelman WA, Slors JF, van Duijvendijk P, Gouma DJ. Functional outcome, quality of life, body image, and cosmesis in patients after laparoscopic-assisted and conventional restorative proctocolectomy: a comparative study. Dis Colon Rectum 2001;44:1800–7.

    Article  PubMed  CAS  Google Scholar 

  9. Georgeson KE. Laparoscopic-assisted total colectomy with pouch reconstruction. Semin Pediatr Surg 2002;11:233–6.

    Article  PubMed  Google Scholar 

  10. Gorfine SR, Gelernt IM, Bauer JJ, Harris MT, Kreel I. Restorative proctocolectomy without diverting ileostomy. Dis Colon Rectum 1995;38:188–94.

    Article  PubMed  CAS  Google Scholar 

  11. Hasegawa H, Watanabe M, Baba H, Nishibori H, Kitajima M. Laparoscopic restorative proctocolectomy for patients with ulcerative colitis. J Laparoendosc Adv Surg Tech A 2002;12:403–6.

    Article  PubMed  Google Scholar 

  12. Hashimoto A, Funayama Y, Naito H, et al. Laparoscope-assisted versus conventional restorative proctocolectomy with rectal mucosectomy. Surg Today 2001;31:210–4.

    Article  PubMed  CAS  Google Scholar 

  13. Hildebrandt U, Lindemann W, Kreissler-Haag D, Feifel G, Ecker KW. [Laparoscopically-assisted proctocolectomy with ileoanal pouch in ulcerative colitis]. Zentralbl Chir 1998;123:403–5.

    PubMed  CAS  Google Scholar 

  14. Kienle P, Weitz J, Benner A, Herfarth C, Schmidt J. Laparoscopically assisted colectomy and ileoanal pouch procedure with and without protective ileostomy. Surg Endosc 2003;17:716–20.

    Article  PubMed  CAS  Google Scholar 

  15. Ky AJ, Sonoda T, Milsom JW. One-stage laparoscopic restorative proctocolectomy: an alternative to the conventional approach? Dis Colon Rectum 2002;45:207–10.

    Article  PubMed  Google Scholar 

  16. Marcello PW, Milsom JW, Wong SK, Hammerhofer KA, Goormastic M, Church JM, Fazio VW. Laparoscopic restorative proctocolectomy: case-matched comparative study with open restorative proctocolectomy. Dis Colon Rectum 2000;43:604–8.

    Article  PubMed  CAS  Google Scholar 

  17. Pace DE, Seshadri PA, Chiasson PM, Poulin EC, Schlachta CM, Mamazza J. Early experience with laparoscopic ileal pouch-anal anastomosis for ulcerative colitis. Surg Laparosc Endosc Percutan Tech 2002;12:337–41.

    Article  PubMed  CAS  Google Scholar 

  18. Santoro E, Carlini M, Carboni F, Feroce A. Laparoscopic total proctocolectomy with ileal J pouch-anal anastomosis. Hepatogastroenterology 1999;46:894–9.

    PubMed  CAS  Google Scholar 

  19. Seshadri PA, Poulin EC, Schlachta CM, Cadeddu MO, Mamazza J. Does a laparoscopic approach to total abdominal colectomy and proctocolectomy offer advantages? Surg Endosc 2001;15:837–42.

    Article  PubMed  CAS  Google Scholar 

  20. Thibault C, Poulin EC. Total laparoscopic proctocolectomy and laparoscopy-assisted proctocolectomy for inflammatory bowel disease: operative technique and preliminary report. Surg Laparosc Endosc 1995;5:472–6.

    PubMed  CAS  Google Scholar 

  21. Watanabe Y, Sato M, Kikkawa H, Yoshida M, Kusunose H, Kawachi K. Hand-assisted laparoscopic total colorectal resection for familial adenomatous polyposis with coexisting rectal cancer. Surg Endosc 2001;15:445–7.

    Article  PubMed  CAS  Google Scholar 

  22. Young-Fadok TM, Dozois E, Sandborn WJ, Tremaine WJ. A case matched study of laparoscopic proctocolectomy and ileal pouch-anal anastomosis (PC-IPAA) versus open PC-IPAA for ulcerative colitis. Gastroenterology 2001;A-452:2302.

    Google Scholar 

  23. Larson DW, Cima RR, Dozois EJ, et al. Safety, feasibility, and short-term outcomes of laparoscopic ileal-pouch-anal anastomosis: a single institutional case-matched experience. Ann Surg 2006;243:667–70.

    Article  PubMed  Google Scholar 

  24. Larson DW, Dozois EJ, Piotrowicz K, Cima RR, Wolff BG, Young-Fadok TM. Laparoscopic-assisted vs. open ileal pouch-anal anastomosis: functional outcome in a case-matched series. Dis Colon Rectum 2005;48:1845–50.

    Article  PubMed  Google Scholar 

  25. Larson DW, Dozois E, Sandborn WJ, Cima R. Total laparoscopic proctocolectomy with Brooke ileostomy: a novel incisionless surgical treatment for patients with ulcerative colitis. Surg Endosc 2005;19:1284–7.

    Article  PubMed  CAS  Google Scholar 

  26. Maartense S, Dunker MS, Slors JF, et al. Hand-assisted laparoscopic versus open restorative proctocolectomy with ileal pouch-anal anastomosis: a randomized trial. Ann Surg 2004;240:984–91.

    Article  PubMed  Google Scholar 

  27. Dozois RR, Nelson H, Metcalf AM. [Sexual function after ileo-anal anastomosis]. Ann Chir 1993;47:1009–13.

    PubMed  CAS  Google Scholar 

  28. Hueting WE, Gooszen HG, van Laarhoven CJ. Sexual function and continence after ileo pouch anal anastomosis: a comparison between a meta-analysis and a questionnaire survey. Int J Colorectal Dis 2004;19:215–8.

    Article  PubMed  CAS  Google Scholar 

  29. Rosen R, Brown C, Heiman J, et al. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 2000;26:191–208.

    Article  PubMed  CAS  Google Scholar 

  30. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997;49:822–30.

    Article  PubMed  CAS  Google Scholar 

  31. Reilly WT, Pemberton JH, Wolff BG, et al. Randomized prospective trial comparing ileal pouch-anal anastomosis performed by excising the anal mucosa to ileal pouch-anal anastomosis performed by preserving the anal mucosa. Ann Surg 1997;225:666–76.

    Article  PubMed  CAS  Google Scholar 

  32. Maartense S, Dunker MS, Slors JF, Gouma DJ, Bemelman WA. Restorative proctectomy after emergency laparoscopic colectomy for ulcerative colitis: a case-matched study. Colorectal Dis 2004;6:254–7.

    Article  PubMed  CAS  Google Scholar 

  33. Olsen KO, Joelsson M, Laurberg S, Oresland T. Fertility after ileal pouch-anal anastomosis in women with ulcerative colitis. Br J Surg 1999;86:493–5.

    Article  PubMed  CAS  Google Scholar 

  34. Jayne DG, Brown JM, Thorpe H, Walker J, Quirke P, Guillou PJ. Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique. Br J Surg 2005;92:1124–32.

    Article  PubMed  CAS  Google Scholar 

  35. Gorgun E, Remzi FH, Montague DK, et al. Male sexual function improves after ileal pouch anal anastomosis. Colorectal Dis 2005;7:545–50.

    Article  PubMed  CAS  Google Scholar 

  36. You YN, Barnes SA, Hassan I, Cima RR. How well do we assess sexual function after colorectal surgery [meeting abstract]? Dis Colon Rectum 2006;49:708.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic Rochester, Rochester, Minnesota, USA

    David W. Larson M.D., Eric J. Dozois M.D., Robert R. Cima M.D., Karen Piotrowicz R.N., Bruce G. Wolff M.D. & John H. Pemberton M.D.

  2. Mayo Clinic College of Medicine, Rochester, Minnesota, USA

    David W. Larson M.D., Eric J. Dozois M.D., Robert R. Cima M.D., Karen Piotrowicz R.N., Kari Anderson B.S., Tonia M. Young-Fadok M.D., Bruce G. Wolff M.D. & John H. Pemberton M.D.

  3. Department of Colorectal Surgery, Llandough Hospital, Cardiff, United Kingdom

    Michael M. Davies M.D.

  4. Division of Biostatistics, Mayo Clinic Rochester, Rochester, Minnesota, USA

    Kari Anderson B.S., Sunni A. Barnes Ph.D. & W. Scott Harmsen M.S.

  5. Division of Colon and Rectal Surgery, Mayo Clinic Scottsdale, Arizona, USA

    Tonia M. Young-Fadok M.D.

Authors
  1. David W. Larson M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael M. Davies M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eric J. Dozois M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Robert R. Cima M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Karen Piotrowicz R.N.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kari Anderson B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sunni A. Barnes Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. W. Scott Harmsen M.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tonia M. Young-Fadok M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Bruce G. Wolff M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. John H. Pemberton M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David W. Larson M.D..

Additional information

Supported by a grant from the Department of Surgery Mayo Clinic Rochester, Minnesota.

About this article

Cite this article

Larson, D.W., Davies, M.M., Dozois, E.J. et al. Sexual Function, Body Image, and Quality of Life after Laparoscopic and Open Ileal Pouch-Anal Anastomosis. Dis Colon Rectum 51, 392–396 (2008). https://doi.org/10.1007/s10350-007-9180-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10350-007-9180-5

Key words

Search

Navigation