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Women's health issues after ileal pouch surgery.

Publication ,  Journal Article
Bharadwaj, S; Philpott, JR; Barber, MD; Graff, LA; Shen, B
Published in: Inflamm Bowel Dis
December 2014

: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for patients with ulcerative colitis and familial polyposis who require colectomy. This surgical intervention allows for resection of colon, while offering intestinal continuity with fecal continence, discontinuation of most medications related to ulcerative colitis and reduction in the risk of colitis-associated neoplasia. As a proportion of these patients are women of childbearing age, it is important to understand the impact on reproductive health and function. Although limited data exist, restorative proctocolectomy/IPAA does not seem to adversely affect menstrual function. In general, sexual function is reported to improve postsurgery with the ability to achieve orgasm unaltered. However, dyspareunia is commonly reported post restoratively. Of concern, there are data to suggest that fertility is decreased post-IPAA. The reasons stated are pelvic adhesions and obstruction of fallopian tubes. Laparoscopic approach may improve fertility outcomes by reducing postoperative adhesions as compared with the open approach. Once achieved, pregnancy in patients with IPAA is characterized by a transient increase in stool frequency that resolves postdelivery. Whether vaginal delivery or cesarean section is preferred route of delivery in these patients is still controversial. But commonly cesarean section is advocated for patients' post-IPAA to prevent anal sphincter injury and long-term effects on pouch function. All of these issues should be included in the discussion with women who are contemplating IPAA, so they are well aware of them before deciding on the best management plan.

Duke Scholars

Published In

Inflamm Bowel Dis

DOI

EISSN

1536-4844

Publication Date

December 2014

Volume

20

Issue

12

Start / End Page

2470 / 2482

Location

England

Related Subject Headings

  • Women's Health
  • Proctocolectomy, Restorative
  • Pregnancy
  • Postoperative Complications
  • Ileum
  • Humans
  • Gastroenterology & Hepatology
  • Female
  • Colonic Pouches
  • Colitis, Ulcerative
 

Citation

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Bharadwaj, S., Philpott, J. R., Barber, M. D., Graff, L. A., & Shen, B. (2014). Women's health issues after ileal pouch surgery. Inflamm Bowel Dis, 20(12), 2470–2482. https://doi.org/10.1097/MIB.0000000000000171
Bharadwaj, Shishira, Jessica R. Philpott, Matthew D. Barber, Lesley A. Graff, and Bo Shen. “Women's health issues after ileal pouch surgery.Inflamm Bowel Dis 20, no. 12 (December 2014): 2470–82. https://doi.org/10.1097/MIB.0000000000000171.
Bharadwaj S, Philpott JR, Barber MD, Graff LA, Shen B. Women's health issues after ileal pouch surgery. Inflamm Bowel Dis. 2014 Dec;20(12):2470–82.
Bharadwaj, Shishira, et al. “Women's health issues after ileal pouch surgery.Inflamm Bowel Dis, vol. 20, no. 12, Dec. 2014, pp. 2470–82. Pubmed, doi:10.1097/MIB.0000000000000171.
Bharadwaj S, Philpott JR, Barber MD, Graff LA, Shen B. Women's health issues after ileal pouch surgery. Inflamm Bowel Dis. 2014 Dec;20(12):2470–2482.
Journal cover image

Published In

Inflamm Bowel Dis

DOI

EISSN

1536-4844

Publication Date

December 2014

Volume

20

Issue

12

Start / End Page

2470 / 2482

Location

England

Related Subject Headings

  • Women's Health
  • Proctocolectomy, Restorative
  • Pregnancy
  • Postoperative Complications
  • Ileum
  • Humans
  • Gastroenterology & Hepatology
  • Female
  • Colonic Pouches
  • Colitis, Ulcerative