Counihan T C, Roberts P L, Schoetz D J, Coller J A, Murray J J, Veidenheimer M C
Department of Colon and Rectal Surgery, Lahey Clinic, Burlington, Massachusetts 01805.
Dis Colon Rectum. 1994 Nov;37(11):1126-9. doi: 10.1007/BF02049815.
This study was designed to determine the incidence of infertility, gynecologic problems, and sexual dysfunction after ileal pouch-anal anastomosis (IPAA).
A questionnaire was sent to 206 females who underwent pouch surgery at a single institution from 1980 through 1991. Response rate was 53 percent (110/206). The computerized registry of the 206 females undergoing IPAA at this institution was reviewed to add additional data.
Mean age at pouch construction was 32 (range, 14-61) years. Mean time from pouch surgery to survey was 49 (range, 1-132) months. Fifty-seven females had 119 children before pouch surgery, and 23 children were born to 19 females after IPAA (5 vaginal deliveries, 18 Cesarean sections). Eighteen females experienced infertility after IPAA. Thirty patients had persistent dyspareunia. Pelvic cysts developed in 15 patients; 11 patients required surgery.
Although childbirth appears safe, gynecologic problems, such as dyspareunia and formation of pelvic cysts, may be underestimated after IPAA. The effects of IPAA on fertility are still unknown.
本研究旨在确定回肠储袋肛管吻合术（IPAA）后不孕、妇科问题及性功能障碍的发生率。
向1980年至1991年间在单一机构接受储袋手术的206名女性发送了问卷。回复率为53%（110/206）。查阅了该机构206名接受IPAA手术女性的计算机登记资料以补充更多数据。
构建储袋时的平均年龄为32岁（范围14 - 61岁）。从储袋手术到调查的平均时间为49个月（范围1 - 132个月）。57名女性在储袋手术前育有119个孩子，19名女性在IPAA术后育有23个孩子（5例顺产，18例剖宫产）。18名女性在IPAA术后出现不孕。30名患者存在持续性性交困难。15名患者出现盆腔囊肿；11名患者需要手术治疗。
尽管分娩似乎是安全的，但IPAA术后诸如性交困难和盆腔囊肿形成等妇科问题可能被低估。IPAA对生育能力的影响仍不清楚。
