GYNECOLOGICAL AND SEXUAL FUNCTION RELATED TO ANATOMICAL CHANGES IN THE FEMALE PELVIS AFTER RESTORATIVE PROCTOCOLECTOMY

Restorative proctocolectomy with an ileal pouch-anal anastomosis prese rves anal sphincters, the normal route of defaecation and the normal b ody image and it has been suggested that the procedure might be associ ated with less gynaecological and sexual problems than conventional pr octocolectomy. To shed further light on this subject 60 female patient s were invited to participate in a study comprising a detailed intervi ew, examination by a gynaecologist and investigation with hysterosalpi ngography and vaginography. Twenty-one women with a mean follow-up of 38 months after surgery agreed to participate. Their gynaecological st ate was considered normal although one woman complained of vaginal dis charge. Five women experienced occasional dyspareunia and 2 patients h ad to take special precautions to avoid bowel leaks at intercourse. Wh ile the position of the vagina and uterus in the pelvis appeared norma l, hysterosalpingography disclosed bilateral occlusion of the fallopia n tubes in 2 and unilateral occlusion in another 9 patients with tubes adhering to the bottom of the lesser pelvis in 10 of the patients. On ly one out of 14 patients succeeded in trying to conceive during the f ollow-up period. Among the remaining 39 women not specially studied 5 out of 14 had conceived after the operation.