The Effect of Restorative Proctocolectomy on Sexual Function, Urinary Function, Fertility, Pregnancy and Delivery: A Systematic Review

Cornish, Julie; Tan, Ek Khoon; Teare, Julian; Teoh, Teoh G.; Rai, Raj; Darzi, Ara; Paraskeva, Paraskevas; Clark, Susan; Tekkis, Paris

doi:10.1007/s10350-007-0240-7

Cited by 197 publications

(148 citation statements)

References 48 publications

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“…Women with UC have been shown to have normal fertility until they have had surgical treatment. 14,15 Recent systematic reviews showed that restorative proctocolectomy (RPC) for UC results in decreased fertility (40% of females conceiving before RPC and only 29 per cent conceiving after RPC) 16 or increased infertility (15-48% in women post-ileal pouch-anal anastomosis for UC). 17 The resultant scarring, adhesions and tubal involvement of the surgery may contribute towards infertility.…”

Section: Decision-making Node #1: Preconceptionmentioning

confidence: 99%

“…12,18 However, the reviews also showed that IVF is a successful fertility treatment after RPC, and that RPC does not pose increased risk to the foetus. 16,19,20 More females who have had RPC have caesarean sections than vaginal deliveries, as it has the potential benefit of decreased risk of faecal incontinence or damage to the anal sphincters and pelvic pouch. 16,19 A small study showed that ileorectal anastomosis preserves female fertility and may be a surgical option when considering effect on fertility.…”

Section: Decision-making Node #1: Preconceptionmentioning

confidence: 99%

“…16,19,20 More females who have had RPC have caesarean sections than vaginal deliveries, as it has the potential benefit of decreased risk of faecal incontinence or damage to the anal sphincters and pelvic pouch. 16,19 A small study showed that ileorectal anastomosis preserves female fertility and may be a surgical option when considering effect on fertility. 21 Although there is no firm data to support the following approach, 22 it is recommended that female patients who are planning to conceive and who require colectomy for acute UC undergo ileostomy and rectal sparing initially and then ileal pouch-anal anastomosis could then be performed after conception, pregnancy, and delivery.…”

Section: Decision-making Node #1: Preconceptionmentioning

confidence: 99%

See 2 more Smart Citations

Review article: a decision‐making algorithm for the management of pregnancy in the inflammatory bowel disease patient

Huang

2012

Aliment Pharmacol Ther

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BackgroundInflammatory bowel disease affects patients who are in their reproductive years. There are many questions regarding the management of IBD patients who are considering or who are already pregnant. These include the effect of the disease and the medications on fertility and on the pregnancy outcome. AimTo create an evidence-based decision-making algorithm to help guide physicians through the management of pregnancy in the IBD patient.

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Section: Decision-making Node #1: Preconceptionmentioning

confidence: 99%

Section: Decision-making Node #1: Preconceptionmentioning

confidence: 99%

Section: Decision-making Node #1: Preconceptionmentioning

confidence: 99%

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Review article: a decision‐making algorithm for the management of pregnancy in the inflammatory bowel disease patient

Huang

2012

Aliment Pharmacol Ther

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“…Similarly, sexual dysfunction post-proctocolectomy depends on the extent of the dissection of the pelvic nerves. Additional predisposing factors include advanced age, radiation, APR, and total mesorectal excision [43][44][45]. On average, 30% to 40% of previously sexually active patients reported sexual dysfunction following treatment [46].…”

Section: Flexible Proctosigmoidoscopy Rectal Cancermentioning

confidence: 99%

After the Treatment Phase of Colorectal Cancer Care: Survivorship and Follow-Up

Ho¹,

Cheung²

2012

JCT

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The number of long-term colorectal cancer (CRC) survivors has increased substantially over the past three decades due to both ongoing advances in early detection and improvements in cancer therapies. Adult survivors of CRC experience chronic health conditions due to normal issues associated with aging, which is further compounded by the long-term adverse effects of having had cancer and anti-cancer therapies. In addition, they are at a higher risk for CRC recurrences, new primary cancers, and other co-morbidities. This article will provide an overview of the clinical care of adult survivors of CRC. Epidemiologic data will be presented followed by a discussion of the approach to the care of long-term adult survivors of CRC, including surveillance of recurrences and new primary cancers, interventions to manage both physical and psychological consequences of cancer and its treatments, and strategies to address concerns related to unemployment and disability. Finally, we will explore the challenges of healthcare delivery, especially with respect to the coordination of follow-up between cancer specialists and primary care physicians, so as to ensure that all of the survivor's health needs are met promptly and appropriately.

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“…impotence, impaired lubrication, pain during intercourse and desire, vary. [8][9][10][11][12][13][14][15][16][17][18][19][20][21] This aspect of quality of life is poorly considered in standard instruments. Reported improvement of sexual function may be an effect of excision of the source of chronic inflammation and a better general health status.…”

Section: Introductionmentioning

confidence: 99%

Sexual function after failed ileal pouch-anal anastomosis

Bengtsson¹,

Lindholm²,

Nordgren³

et al. 2011

Journal of Crohn's and Colitis

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Background and Aims: Failure of ileal pouch-anal anastomosis (IPAA) occurs in around 10% of the patients. Compared to patients with functioning pouches, health related quality of life is deteriorated after failure. Sexual function in patients with pouch failure is however poorly studied. The aim was to study sexual function in patients with pelvic pouch failure; patients with functioning pouches were used as controls. The hypothesis was that patients with pouch failure have worse sexual function. Methods: 36 patients with pouch failure were compared with 72 age and sex-matched controls with ulcerative colitis and functioning pouches. The patients answered a set of questionnaires concerning sexual function (Female Sexual Function Index [FSFI] and International Index of Erectile Function [IIEF]), body image (BIS-scale) and health-related quality of life (SF-36). Results: Both women and men with pouch failure scored lower than controls in the FSFI and IIEF questionnaires. However, none of the observations were statistically significant. The scores in the failure group (for both sexes) were below the cut-off level for sexual dysfunction. Scores for the BIS instrument were significantly lower for both sexes in the failure group. Women and men in the failure group scored lower than the controls in all domains of the SF-36, however statistically significant only for the social function domain in men. Conclusions: The hypothesis, that a failed IPAA is associated with worse sexual function, was not confirmed. Compared to patients with functioning pouches, patients with pouch failure have inferior body image.

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The Effect of Restorative Proctocolectomy on Sexual Function, Urinary Function, Fertility, Pregnancy and Delivery: A Systematic Review

Cited by 197 publications

References 48 publications

Review article: a decision‐making algorithm for the management of pregnancy in the inflammatory bowel disease patient

Review article: a decision‐making algorithm for the management of pregnancy in the inflammatory bowel disease patient

After the Treatment Phase of Colorectal Cancer Care: Survivorship and Follow-Up

Sexual function after failed ileal pouch-anal anastomosis

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