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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.
Intramesorectal (IME) proctectomy for ulcerative colitis (UC) offers better fecal continence than total mesorectal excision (TME). However, both surgical approaches show similar outcomes for overall bowel and sexual function in UC patients.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Urology
Background:
- Ulcerative colitis (UC) management often involves proctectomy.
- Surgical options include intramesorectal (IME) and total mesorectal excision (TME).
Purpose of the Study:
- To compare patient-reported bowel and sexual function after IME versus TME proctectomy for UC.
Main Methods:
- Retrospective comparison of 89 UC patients undergoing IME or TME between September 2000 and March 2011.
- Utilized validated surveys: MSKCC Bowel Function scale, Fecal Incontinence Quality of Life, Fecal Incontinence Severity Index, Female Sexual Function Instrument, and International Index of Erectile Dysfunction.
Main Results:
- IME patients reported significantly better fecal continence (P = .009).
- No significant differences were observed in fecal incontinence-related quality of life (P ≥ .44).
- Both women (FSFI; P ≥ .20) and men (IIEF; P ≥ .22) showed no differences in sexual function between IME and TME groups.
Conclusions:
- Intramesorectal excision (IME) may lead to improved fecal continence following proctectomy for ulcerative colitis.
- Overall bowel function and sexual function outcomes appear comparable between IME and TME approaches in UC patients.
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