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Does intramesorectal excision for ulcerative colitis impact bowel and sexual function when compared with total
Caitlin W Hicks1, Richard A Hodin2, Lieba Savitt2
1Department of Surgery, Massachusetts General Hospital Crohn's and Colitis Center, Boston, MA, USA; Department of Surgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Background:
Proctectomy for ulcerative colitis (UC) can be performed via intramesorectal (IME) or total mesorectal excision (TME).
Methods:
We compared patient-reported bowel and sexual function among IME versus TME UC patients (September 2000 to March 2011) using the Memorial Sloan-Kettering Cancer Center Bowel Function scale, Fecal Incontinence Quality of Life, Fecal Incontinence Severity Index, Female Sexual Function Instrument, and International Index of Erectile Dysfunction surveys.
Results:
Eighty-nine IME versus TME patients (35 ± 2 years, 57% male, 62% IME) had similar baseline characteristics, although IME patients had more open procedures (P ≤ .03). IME patients reported better fecal continence (P = .009) but similar fecal incontinence-related quality of life (P ≥ .44). For sexual function, there were no differences for either women (Female Sexual Function Instrument; P ≥ .20) or men (International Index of Erectile Dysfunction; P ≥ .22).
Conclusions:
IME appears to be associated with better fecal continence but no difference in overall bowel or sexual function compared with TME in patients with UC.
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