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Related Experiment Videos

Effect of vaginal delivery on long-term pouch function.

S W Polle1, M S Vlug, J F M Slors

  • 1Department of Surgery, Academic Medical Centre, The Netherlands.

The British Journal of Surgery
|June 17, 2006
PubMed
Summary

Vaginal delivery after restorative proctocolectomy (RP) can impair long-term ileal pouch function, especially in women with a high risk of obstetric injury. Age and longer follow-up worsen incontinence after childbirth post-RP.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Obstetrics

Background:

  • Optimal childbirth method for women with restorative proctocolectomy (RP) remains unclear.
  • Limited data exists on long-term ileal pouch function following vaginal delivery, particularly when childbirth precedes RP.

Purpose of the Study:

  • To assess the impact of vaginal delivery, both before and after RP, on long-term ileal pouch function.

Main Methods:

  • A cohort of 267 women who underwent RP between 1985 and 2004 were surveyed.
  • Functional outcomes were evaluated using a colorectal functional outcome questionnaire.
  • Linear regression identified risk factors for poor pouch function.

Main Results:

  • 82.6% response rate; median follow-up 7.2 years.

Related Experiment Videos

  • Of 86 women attempting vaginal delivery, 52 (60%) had risk factors for obstetric injury.
  • Ageing and longer follow-up were significant risk factors for incontinence in these patients.

    • Conclusions:

    • Vaginal delivery in women with RP and high obstetric injury risk leads to impaired continence over time.
    • Informed consent regarding the risks of vaginal delivery on ileal pouch function is crucial for patients undergoing RP.