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

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Sexual Medicine

Background:

• Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, significantly impact patients' quality of life, particularly sexual function.
• Proctectomy is a common surgical intervention for IBD, involving pelvic dissection that may affect sexual function.

Purpose of the Study:

• To evaluate the impact of pelvic dissection during proctectomy on the sexual function of IBD patients.
• To assess changes in sexual function six months after proctectomy, considering factors like gender, age, disease type, and surgical procedure.

Main Methods:

• A prospective study of 57 IBD patients undergoing proctectomy between 2010 and 2016.
• Utilized the 5-item International Index of Erectile Function (IIEF-5) for men and the Female Sexual Function Index for women to assess pre- and postoperative sexual function.
• Analyzed the influence of gender, age, disease type (Crohn's disease, ulcerative colitis), and surgical approach (IPAA vs. permanent ileostomy).

Main Results:

• No significant changes in sexual function scores were observed for men (IIEF-5 median 22.0 vs. 23.0) or women (overall median 23.0 vs. 24.1) six months post-proctectomy.
• The majority of men experienced no erectile dysfunction before or after surgery (56.4% vs. 51.3%).
• Female patients consistently scored below the threshold for adequate sexual function (26.5) across most subgroups.

Conclusions:

• Proctectomy in IBD patients does not appear to negatively affect sexual function six months after surgery.
• Female IBD patients undergoing proctectomy may experience more persistent issues with sexual function compared to their male counterparts.