Functional outcomes after ileal pouch-anal anastomosis for chronic ulcerative colitis

Objective To assess long-term outcomes after ileal pouch-anal anastomosis ( IPAA) for chronic ulcerative colitis (CUC) with specific emphasis on patien t sex, childbirth, and age, Summary Background Data Childbirth and the process of aging affect pelvic f loor and anal sphincter function independently. Early function after IPAA i s good for most patients. Nonetheless, there are concerns about the impact of the aging process as weil as pregnancy on long-term functional outcomes after IPAA. Methods Functional outcomes using a standardized questionnaire were prospec tively assessed for each patient on an annual basis. Results Of the 1,454 patients who underwent IPAA for CUC between 1981 and 1 994, 1,386 were part of this study. Median age was 32 years. Median length of follow-up was 8 years. Pelvic sepsis was the primary cause of pouch fail ure irrespective of sex or age. Functional outcomes were comparable between men and women. Eighty-five women who became pregnant after IPAA had pouch function, which was comparable with women who did not have a child. Daytime and nocturnal incontinence affected older patients more frequently than yo unger ones. Incontinence became more common the longer the follow-up in old er patients, but this was not found in younger patients. Poor anal function led to pouch excision in only 3 of 204 older patients, Conclusions Incontinence rates were significantly higher in cider patients after IPAA for CUC compared with younger patients. However, this did not co ntribute to a greater risk of pouch failure in these older patients. Patien t sex and uncomplicated childbirth did not affect long-term functional outc omes.