Abstract
PURPOSE: Patiens who undergo surgery for ulcerative colitis are usually young and active. When surgery becomes necessary, their future social and sexual function is of major concern. This study was performed to be able to give more detailed information of what is to be expected. METHODS: Forty-nine consecutive patients (26 men and 23 women) who underwent ileal J-pouch-anal anastomosis for ulcerative colitis between November 1983 and September 1986 in the authors' institution were personally interviewed regarding details of their preoperative and postoperative social and sexual functions. RESULTS: Eighty-eight percent had reduced capacity to work preoperatively compared with 6 percent postoperatively. Thirty-one percent resumed work in the period with diverting ileostomy. Leisure time activities were reduced in 47 percent preoperatively, whereas 6 percent had limitations postoperatively. In 35 percent of women, frequency of intercourse was increased postoperatively, and none reported a decreased frequency. None of the women who were able to achieve orgasm preoperatively reported a postoperative disturbance of this ability, and 16 percent experienced an increased quality of orgasm. Postoperatively none reported dyspareunia, vaginal discharge, or changes in their menstrual cycle. Frequency of intercourse and ability to achieve orgasm remained unchanged for the majority of men; however, one developed erectile dysfunction, and one complained of retrograde ejaculation. Sexual activity in men was less affected by the presence of an ileostomy, and 69 percent had intercourse in the period with ileostomy compared with 30 percent of women. None of the patients complained of anal pain, soiling, or fecal leakage during intercourse, but one woman reported some discomfort from the pouch during intercourse. None of the patients wanted to return to a life with an ileostomy. CONCLUSION: The social and sexual function, quality of life, after ileal J-pouch anastomosis is improved when compared with the period with ulcerative colitis and the time with diverting ileostomy. In men, however, a frequency of sexual dysfunction similar to what is seen after proctectomy for benign diseases should be underlined.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Pemberton JH, Kelly KA, Beart RW, Dozois RR, Wolff GB, Ilstrup DM. Ileal pouch-anal anastomosis for chronic ulcerative colitis: long-term results. Ann Surg 1987;206:504–11.
Williams NS, Johnston D. The current status of mucosal proctectomy and ileo-anal anastomosis in the surgical treatment of colitis and adenomatous polyposis. Br J Surg 1985;72:159–68.
Oresland T, Fasth S, Mordgren S, Hultén L. The clinical and functional outcome after restorative proctocolectomy: a prospective study in 100 patients. Int J Colorectal Dis 1989;32:323–6.
Wettergren A, Gyrtrup HJ, Grosmann E,et al. Complications after J-pouch ileoanal anastomosis: stapled compared with handsewn anastomosis. Eur J Surg 1993;159:121–4.
Kirkegaard P, Bülow S, Olsen Skov P, Gyrtrup HJ. The first year with a J-pouch: a prospective evaluation. Int J Colorectal Dis 1990;5:148–50.
Cohen Z, Mcleod RS, Stephen W, Stern HS, O'Conner B, Reznick R. Continuing evaluation of the pelvic pouch procedure. Ann Surg 1992;216:506–11.
Wexner SD, Jensen L, Rothenberger DA, Wong WD, Goldberg SM. Long-term functional analysis of the ileoanal reservoir. Dis Colon Rectum 1989;32:275–81.
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;206:620–6.
Köhler LW, Pemberton JH, Zinsmeister AR, Kelly KA. A comparison of Brooke ileostomy, Kock pouch, and ileal pouch-anal anastomosis. Gastroenterology 1991;101:679–84.
Morowitz DA, Kisner JB. Ileostomy in ulcerative colitis: a questionnaire study of 1803 patients. Am J Surg 1981;141:370–5.
Roy PH, Sauer WG, Beahrs OH, Farrow GM. Experience with ileostomies: evaluation of long-term rehabilitation in 497 patients. Am J Surg 1970;119:77–86.
Boné J, Sorensen FH. Life with a conventional ileostomy. Dis Colon Rectum 1974;17:194–9.
Druss RG, O'Conner JF, Prudden JS, Stern O. Psychologic response to colectomy. Arch Gen Psychiatry 1968;18:53–9.
Failes D. The Kock continent ileostomy: a preliminary report. Aust N Z J Surg 1976;46:125–30.
Metcalf AM, Dozois RR, Kelly KA. Sexual function in women after proctocolectomy. Ann Surg 1986;204:624–7.
Bauer JL, Gerlernt IM, Salky B, Kreel I. Sexual dysfunction following proctocolectomy for benign disease of the colon and rectum. Ann Surg 1983;197:363–7.
Yeager ES, Van Heerden JA. Sexual dysfunction following proctocolectomy and abdominoperineal resection. Ann Surg 1980;191:169–70.
Awad RW, El-Gohary TM, Skilton JS, Elder JB. Life quality and psychological morbidity with an ileostomy. Br J Surg 1993;80:252–3.
Author information
Authors and Affiliations
About this article
Cite this article
Damgaard, B., Wettergren, A. & Kirkegaard, P. Social and sexual function following ileal pouch-anal anastomosis. Dis Colon Rectum 38, 286–289 (1995). https://doi.org/10.1007/BF02055604
Issue Date:
DOI: https://doi.org/10.1007/BF02055604