Sexual function after proctectomy in patients with inflammatory bowel disease: A prospective study

Özet

Background/Aims: Inflammatory bowel diseases (IBD), Crohn’s disease (CD) and ulcerative colitis (UC) show a multifactorial impact onpatients’ quality of life, including sexual function (SF). The need for surgical intervention remains high, whereas proctectomy is frequently required in these patients. We tried to evaluate the impact of pelvic dissection during proctectomy in IBD patients’ SF.Materials and Methods: We conducted a prospective study, examining the pre- and postoperative (at 6 months) SF of 57 IBD patientsthat underwent proctectomy in our surgical department, in the period between 2010 and 2016. The 5-item International Index of ErectileFunction (IIEF-5) and the Female Sexual Function Index were our research tools for men and women, respectively. We tried to evaluatethe impact of gender, age, type of the disease, and surgical procedure on postoperative outcome.Results: Ileal pouch-anal anastomosis (IPAA) was offered to 45 patients, whereas 12 patients underwent total proctocolectomy withpermanent end ileostomy (TPC). Men showed a non-significant improvement in median IIEF-5 score after proctectomy (22.0 vs 23.0,p=0.152). The majority of men had no erectile dysfunction either before (56.4%) or after (51.3%) surgery (p=0.599). Changes remainedinsignificant for subgroup analysis according to age, disease and surgical procedure. Female patients had also a non-significant improvement in overall median score (23.0 vs 24.1, p=0.856). Women’s score remained below the cut-off value of 26.5 for almost everysubgroup analyzed.Conclusions: Proctectomy did not affect SF of IBD patents six months after surgery. Female patients seem to face more frequently apoor SF compared to men.