Continence alterations after ileal pouch-anal anastomosis do not diminish quality of life.
OBJECTIVE
This study was conducted to compare continence after double-stapled ileal pouch-anal anastomosis and laparoscopic cholecystectomy using the Fecal Incontinence Severity Index and to assess the impact on quality of life using the Fecal Incontinence Quality of Life Scale.


METHODS
Fifty-five patients randomly selected from a prospective pelvic pouch database were matched with regard to age and gender with patients who had undergone laparoscopic cholecystectomy during the same time interval by the same surgeon. Patients were mailed the two questionnaires, which were reviewed by an independent observer. Demographics, duration since surgery, and functional results were recorded. The Fecal Incontinence Severity Index and Fecal Incontinence Quality of Life scores were compared by the analysis of variance method.


RESULTS
Fifty-one pelvic pouch and 50 laparoscopic cholecystectomy patients were able to be contacted and completed both of the measuring tools. For the pouch patients, the median number of bowel movements per day was six (range, 2-15), with two patients reporting more than occasional nighttime incontinence. Mean incontinence scores were higher for the pelvic pouch patients than for the laparoscopic cholecystectomy patients (17.8 vs. 10.7; P = 0.03). However, the quality-of-life scores were very similar: lifestyle (3.8 vs. 3.83; P = 0.88), depression/self-perception (3.81 vs. 3.83; P = 0.94), embarrassment (3.76 vs. 3.8; P = 0.84), and behavior/coping (3.57 vs. 3.71; P = 0.5).


CONCLUSIONS
Although continence is clearly altered after pelvic pouch surgery, quality of life is extremely well preserved.
Holubar
Stefan
S
Department of Surgery, University of Vermont College of Medicine, Burlington, Vermont, USA.
Hyman
Neil
N
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000009:adverse effects* / Q000379:methods; D017081:Cholecystectomy, Laparoscopic; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000601:surgery*; D039021:Colonic Pouches / Q000473:pathology; D005242:Fecal Incontinence / Q000503:physiopathology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D016737:Proctocolectomy, Restorative / Q000009:adverse effects* / Q000379:methods; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome