title: Does intramesorectal excision for ulcerative colitis impact bowel and sexual function when compared with total mesorectal excision?
abstract: BACKGROUND
  Proctectomy for ulcerative colitis (UC) can be performed via intramesorectal (IME) or total mesorectal excision (TME).
  
  
  METHODS
  We compared patient-reported bowel and sexual function among IME versus TME UC patients (September 2000 to March 2011) using the Memorial Sloan-Kettering Cancer Center Bowel Function scale, Fecal Incontinence Quality of Life, Fecal Incontinence Severity Index, Female Sexual Function Instrument, and International Index of Erectile Dysfunction surveys.
  
  
  RESULTS
  Eighty-nine IME versus TME patients (35 ± 2 years, 57% male, 62% IME) had similar baseline characteristics, although IME patients had more open procedures (P ≤ .03). IME patients reported better fecal continence (P = .009) but similar fecal incontinence-related quality of life (P ≥ .44). For sexual function, there were no differences for either women (Female Sexual Function Instrument; P ≥ .20) or men (International Index of Erectile Dysfunction; P ≥ .22).
  
  
  CONCLUSIONS
  IME appears to be associated with better fecal continence but no difference in overall bowel or sexual function compared with TME in patients with UC.
authors.affiliation: Department of Surgery, Massachusetts General Hospital Crohn's and Colitis Center, Boston, MA, USA; Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Caitlin W
authors.initials: CW
authors.lastname: Hicks
authors.affiliation: Department of Surgery, Massachusetts General Hospital Crohn's and Colitis Center, Boston, MA, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hodin
authors.affiliation: Department of Surgery, Massachusetts General Hospital Crohn's and Colitis Center, Boston, MA, USA.
authors.forename: Lieba
authors.initials: L
authors.lastname: Savitt
authors.affiliation: Department of Surgery, Massachusetts General Hospital Crohn's and Colitis Center, Boston, MA, USA. Electronic address: lbordeianou@partners.org.
authors.forename: Liliana
authors.initials: L
authors.lastname: Bordeianou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003082:Colectomy / Q000379:methods / Q000523:psychology; D003093:Colitis, Ulcerative / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D003672:Defecation / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods* / Q000523:psychology; D011788:Quality of Life; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D019529:Sexuality / Q000502:physiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Functional outcomes; Ileal pouch anal anastomosis; Intramesorectal excision; Quality of life; Total mesorectal excision; Ulcerative colitis