Quality of life after colectomy. A comparison of conventional ileostomy and sphincter saving continent procedures.

The quality of life before and after both ileostomy and continent procedures. Park's pouch with an ileoanal anastomosis a straight ileoural anastomosis and Koch's ileostomy was compared amongst members of the Ileostomy Association. Of 860 patients who were asked to complete questionnaires about aspects of their quality of life, 80% replied. They were all matched for symptoms preoperatively. Fourty-eight had undergone continent procedures. Postoperatively patients with continent procedures had significantly more symptoms. Although the mean frequency of "defaecation" improved in all patients, except those with ileoanal anastomoses, faecal incontinence remained a problem in 26% of those with Park's pouch, 33% with an ileoanal anastomosis and 9% with Koch's ileostomy. Mood improved most in those with either Park's pouch or ileoanal anastomosis. Sexual problems were similar regardless of operative procedure. Our results cast serious doubts on the efficacy of continent procedures.