Psychosocial adaptation to ileostomy: a study after construction of conventional and continent stomies.

Psychosocial adaptation to conventional (n = 33) and to continent (n = 35) ileostomies was compared at a mean interval of 8 years after surgery. At the interview those with conventional ileostomies expressed better preoperative comprehension of the procedure and more satisfaction about its life-saving nature; nevertheless, they experienced more negative emotional reactions, such as bitterness, after the operation. Those with continent ileostomies were more often highly satisfied with their present situation (20% versus 6%; p less than 0.01). Significant limitations in work (15% versus 3%), hobbies (12% versus 0%), social contacts (9% versus 0%), sexual life (6% versus 0%), and mental health (3% versus 0%) were reported constantly less in the continent ileostomy group. Differences were even clearer when the patients with continent stomies compared their present situation with that before conversion of conventional stomy. Patient satisfaction could not be explained by underlying personality features or by psychopathology and was probably the result of the continent ileostomy reconstruction itself. From the psychosocial point of view the use of the Kock continent ileostomy received further support, even though it constituted a higher risk of surgical complications.