Ileal J-pouch anal anastomosis, sexual dysfunction, and fertility

Background: Our aim was to establish what kind of changes take place in sex ual functions after restorative proctocolectomy and ileoanal anastomosis wi th J-pouch (IAA) and whether the operation alters fertility. Methods: One h undred and ten consecutive patients who underwent IAA operation for ulcerat ive colitis at our institute were sent a questionnaire after at least 2 yea rs' follow-up with special emphasis on sexual functions. Analysis was made by an independent researcher. Results: Ninety-five patients (86.7%) respond ed to the questionnaire. The mean follow-up of the patients was 71.5 months (range, 30-128 months). The median age of the 51 women in this study was 3 9.0 years (range, 23-74 years). Dyspareunia increased after the operation, but sexual satisfaction improved. The operation seems to reduce fertility s lightly in women, and the rate of spontaneous abortion may be higher than i n the normal population. The median age of the men was 43.0 (25-69) years. One (2.3%) case of retrograde ejaculation and six (14.6%) cases of erectile function problems were reported after the operation. The fear of leakage d uring coitus were reduced. Conclusions: Sexual satisfaction is improved aft er operation, mainly due to improved general health, despite minor disturba nces in sexual function. There may be a risk of decreased fertility after r estorative proctocolectomy.