Chapter 41 - Male Issues of the Ileal Pouch

Abstract

There are special issues related to male gender before and after ileal pouch surgery. Chronic pouchitis, particularly ischemic pouchitis, anastomoiss or the tip of the “J” leaks, and presacral sinus are more common in males than their females. Sexual dysfunction may occur after pouch surgery, particularly in those with pouch failure. Diagnosis and management of benign and malignant prostate disorders can be challenging due to the altered pelvic anatomy from the surgery. Digital rectal examination for prostate cancer screening is not reliable. Trans-pouch biopsy of prostate may lead to pouch fistula or abscess and therefore transperineal or transgluteal approach is advocated. Pelvic radiation therapy may have an adverse impact on the pouch function.