Gklavas Antonios, Kyprianou Christofis, Exarchos Georgios, Metaxa Linda, Dellis Athanasios, Papaconstantinou Ioannis
2nd Surgical Department, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Department of Radiology, St Bartholomew's Hospital, London, UK.
Turk J Gastroenterol. 2019 Nov;30(11):943-950. doi: 10.5152/tjg.2019.18676.
BACKGROUND/AIMS: Inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) show a multifactorial impact on patients' quality of life, including sexual function (SF). The need for surgical intervention remains high, whereas proctectomy is frequently required in these patients. We tried to evaluate the impact of pelvic dissection during proctectomy in IBD patients' SF.
We conducted a prospective study, examining the pre- and postoperative (at 6 months) SF of 57 IBD patients that underwent proctectomy in our surgical department, in the period between 2010 and 2016. The 5-item International Index of Erectile Function (IIEF-5) and the Female Sexual Function Index were our research tools for men and women, respectively. We tried to evaluate the impact of gender, age, type of the disease, and surgical procedure on postoperative outcome.
Ileal pouch-anal anastomosis (IPAA) was offered to 45 patients, whereas 12 patients underwent total proctocolectomy with permanent end ileostomy (TPC). Men showed a non-significant improvement in median IIEF-5 score after proctectomy (22.0 vs 23.0, p=0.152). The majority of men had no erectile dysfunction either before (56.4%) or after (51.3%) surgery (p=0.599). Changes remained insignificant for subgroup analysis according to age, disease and surgical procedure. Female patients had also a non-significant improvement in overall median score (23.0 vs 24.1, p=0.856). Women's score remained below the cut-off value of 26.5 for almost every subgroup analyzed.
Proctectomy did not affect SF of IBD patents six months after surgery. Female patients seem to face more frequently a poor SF compared to men.
背景/目的：炎症性肠病（IBD）、克罗恩病（CD）和溃疡性结肠炎（UC）对患者的生活质量有多方面影响，包括性功能（SF）。手术干预的需求仍然很高，而这些患者经常需要进行直肠切除术。我们试图评估IBD患者直肠切除术中盆腔清扫对其性功能的影响。
我们进行了一项前瞻性研究，调查了2010年至2016年期间在我们外科接受直肠切除术的57例IBD患者术前及术后（6个月时）的性功能。国际勃起功能指数5项问卷（IIEF-5）和女性性功能指数分别是我们针对男性和女性的研究工具。我们试图评估性别、年龄、疾病类型和手术方式对术后结果的影响。
45例患者接受了回肠储袋肛管吻合术（IPAA），而12例患者接受了全直肠结肠切除术并永久性末端回肠造口术（TPC）。男性直肠切除术后IIEF-5评分中位数有非显著性改善（22.0对23.0，p = 0.152）。大多数男性术前（56.4%）和术后（51.3%）均无勃起功能障碍（p = 0.599）。根据年龄、疾病和手术方式进行亚组分析时，变化仍无显著性。女性患者总体评分中位数也有非显著性改善（23.0对24.1，p = 0.856）。在几乎每个分析的亚组中女性评分均低于26.5的临界值。
直肠切除术在术后6个月未影响IBD患者的性功能。与男性相比，女性患者似乎更常面临性功能较差的情况。
