Does intramesorectal excision for ulcerative colitis impact bowel and sexual function when compared with total mesorectal excision?

Abstract

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.

Keywords: Functional outcomes; Ileal pouch anal anastomosis; Intramesorectal excision; Quality of life; Total mesorectal excision; Ulcerative colitis.