Functional Outcomes, Quality of Life, Sexual Function, and Fertility of Adult Patients Undergoing Ileo-Anal Pouch Anastomosis in Childhood
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In brief
In brief
Long-term follow-up of 70 patients who underwent IPAA in childhood (mean age 14) shows preserved pouch function and sexual function into adulthood, but quality of life scores are lower than adult series. Female fertility appears maintained though pregnancy complications were noted in this cohort.
Written by the GCMD Library team from the article.
Background
We conducted a questionnaire-based study of pouch function, quality of life, sexual function, and fertility among patients who had undergone ileal pouch anal anastomosis (IPAA) in childhood and who are now over 18 years old.
Methods
A consecutive series of patients were asked to complete the following questionnaires: Pouch Function Score (PFS), Short Form 36 (SF-36), International Index of Erectile Function (IIEF) (males), and Female Sexual Function Index (FSFI) (females). Fertility in females was also assessed. Data are quoted as a median (SD).
Results
Of 144 patients who had IPAA, 101 were eligible, and 70 responded. Mean age at surgery was 14 years, and mean current age is 26 years. Most patients had either ulcerative colitis or familial adenomatous polyposis. The questionnaire was completed by 38/70 (54%). Median PFS score was 6 (5). SF-36 were lower than previous reports. Median FSFI was 30 (7.6), 84% of possible maximum. Median IIEF was 69, 92% of possible maximum. Successful conception was reported in 5/7 women who had tried. However, there were several miscarriages and two surgical emergencies during pregnancies.
Conclusions
IPAA can be performed in childhood with similar pouch function to reported adult series. Quality of life appears poorer, but sexual function is maintained. There may be an association with adverse events in pregnancy.