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Sexual function in women after proctocolectomy.

A M Metcalf, R R Dozois, K A Kelly

    Annals of Surgery
    |December 1, 1986
    PubMed
    Summary
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    Proctocolectomy surgery for ulcerative colitis or polyposis coli improved sexual function for most women. While Kock pouches had higher rates of dyspareunia, overall sexual health and intercourse frequency increased post-surgery.

    Area of Science:

    • Gastroenterology
    • Colorectal Surgery
    • Sexual Health

    Background:

    • Ulcerative colitis and polyposis coli often necessitate proctocolectomy.
    • Continence-preserving surgical options include Kock pouches and ileoanal anastomoses.
    • The impact of these procedures on female sexual function requires further investigation.

    Purpose of the Study:

    • To evaluate and compare preoperative and postoperative sexual function in women undergoing proctocolectomy with Kock pouches versus ileoanal anastomoses.
    • To identify differences in sexual function outcomes between the two surgical techniques.

    Main Methods:

    • A cohort of 100 women who underwent proctocolectomy for ulcerative colitis or polyposis coli were interviewed.
    • Participants were divided into two groups: 50 with Kock pouches and 50 with ileoanal anastomoses.

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  • Sexual function, including intercourse frequency, dyspareunia, orgasm, menstrual cycle, vaginal discharge, and fertility, was assessed pre- and post-surgery.

    • Main Results:

    • Overall, sexual function improved post-proctocolectomy, with increased intercourse frequency and decreased dyspareunia.
    • Women with Kock pouches experienced a higher incidence of persistent postoperative dyspareunia (38%) compared to ileoanal anastomosis (18%).
    • Kock pouch patients reported more episodic vaginal discharge (18%) than ileoanal anastomosis patients (0%).

    Conclusions:

    • Proctocolectomy for benign conditions generally enhances sexual function in women, primarily due to improved overall health.
    • While ileoanal anastomoses appear to offer better outcomes regarding dyspareunia and vaginal discharge compared to Kock pouches, both procedures can lead to positive sexual function changes.
    • Postoperative fertility is minimally affected, and disturbances in achieving orgasm are rare.