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


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.


CONCLUSIONS
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.
Hueting
W E
WE
Department of Surgery, University Medical Center, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands. w.e.hueting@chir.azu.nl
Gooszen
H G
HG
van Laarhoven
C J H M
CJ
D000293:Adolescent; D000328:Adult; D004414:Dyspareunia / Q000209:etiology; D004542:Ejaculation; D007172:Erectile Dysfunction / Q000209:etiology*; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010388:Pelvis; D019449:Pouchitis / Q000209:etiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D011788:Quality of Life; D018805:Sepsis / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology; D011795:Surveys and Questionnaires