Baumel H, Fabre J M, Manderscheid J C, Domergue J, Visset J
Service de Chirurgie digestive C, Hôpital Saint-Eloi, Montpellier.
Presse Med. 1994 Dec 17;23(40):1849-53.
To evaluate the medical (sexual dysfunction, psychological adjustment, stoma care) and social (working life, family life, leisure) consequences of definitive ileostomies or colostomies.
From February 1992 to May 1992, 1082 live patients (978 colostomies and 104 ileostomies) who had undergone surgery at least 6 months earlier were assessed in a multicentre national inquiry.
More than 20% of the patients had not been informed before surgery of the possibility of a definitive stoma. In half of the cases, the stoma was well accepted psychologically and patient's primary reactions improved with time, especially in patients with ileostomy (p < 0.01) and patients under 60 years of age (p < 0.001). Patients were satisfied with their stoma appliance in 94% of the cases. Only 31% with colostomy performed irrigations. Life style was altered in 43% of the patients, especially those with ileostomies (p < 0.001). Sexual activity was disturbed in 55% of the colostomy patients and working life in 63% of the ileostomy patients. One-fourth of the patients were often followed by an enterostomal therapist and one-third were members of ostomate associations.
Ileostomy appears to be more disabilitating than colostomy due to patient age and, unlike colostomy, the impossibility of irrigation. These findings emphasize the contribution of enterostomal therapy and the justified role of ostomate associations.
