Ileal pouch anal anastomosis in women of childbearing age: The impact of surgery upon sexual function, fertility, pregnancy, and mode of delivery

Abstract

Proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the mainstay of surgical management for medically refractory ulcerative colitis as well as familial adenomatous polyposis. These procedures are often performed on women of childbearing age and therefore have significant potential impact on future childbearing for these patients. Specifically, IPAA may result in variable changes in sexual function and a well-documented decrease in fertility, likely secondary to distortion of fallopian anatomy and adhesions after dissection. Knowledge of these aspects of IPAA are important for colorectal surgeons as they counsel patients preoperatively and for both colorectal surgeons and obstetricians as they advise their patients with IPAA post-operatively on matters related to sexual function, reproductive health, and delivery.