Sexual function after proctectomy in patients with inflammatory bowel disease: A prospective study

Gklavas, Antonios; Kyprianou, Christofis; Exarchos, Georgios; Metaxa, Linda; Dellis, Athanasios; Papaconstantinou, Ioannis

doi:10.5152/tjg.2019.18676

Cited by 20 publications

(12 citation statements)

References 36 publications

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“…Our study demonstrated significant heterogeneity across the 20 participating Italian hospitals in the number of cases performed per year, with 11 hospitals (55%) performing less than five procedures during the 12 months recruitment period. Rectal resection in CD can be particularly difficult in view of adhesions, inflammation and chronic pelvic abscesses, with possible implications on postoperative functional outcomes such as genitourinary function [ 16 ]. Of the 16 hospitals performing at least one procedure between completion proctectomy and proctocolectomy, only four (25%) performed at least three procedures per year, which could also reflect on the difficulties for surgeons in training to accumulate exposure to these complex procedures [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of colonic Crohn’s disease: a national snapshot study

Celentano¹,

Pellino²,

Rottoli³

et al. 2020

Langenbecks Arch Surg

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Aim The different surgical options for patients with colonic Crohn’s disease (CD) include segmental colectomy, subtotal colectomy or proctocolectomy with end ileostomy. We present a national, multicentre study, promoted by the Italian Society of Colorectal Surgery with the aim to collect benchmark data and national variations on multidisciplinary management and postoperative outcomes of patients undergoing surgery for colonic CD. Methods All adult patients having elective surgery for colonic CD from June 2018 to May 2019 were eligible for participation in this retrospective study. The primary outcome measure was postoperative morbidity within 30 days of surgery. Results One hundred twenty-two patients were included: 55 subtotal colectomy, 30 segmental colectomy, 25 proctectomy and 12 proctocolectomy. Eighty-six patients (70.4%) were discussed at the inflammatory bowel disease (IBD) multidisciplinary team meeting (MDT) prior to surgery. This ranged from 76.6% for segmental colectomy to 60% for subtotal colectomy, 66.6% for proctocolectomy and 48% for proctectomy. The proportion of patients counselled by a stoma nurse preoperatively was 50%. Laparoscopy was associated with reduced postoperative morbidity (p = 0.017) and shorter length of hospital stay (p < 0.001), whilst pre-operative anti-TNF was associated with Dindo-Clavien ≥ 3 complications (p = 0.023) and longer in-hospital stay (p = 0.007). The main procedure performed (segmental colectomy, subtotal colectomy, proctocolectomy or proctectomy) was not associated with postoperative morbidity (p = 0.626). Conclusions Surgery for colonic CD has a high rate of postoperative complications. Almost a third of the patients were not preoperatively discussed at the IBD MDT, whilst the use of minimally invasive surgery for surgical treatment of colonic CD ranges from 40 to 66%.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment of colonic Crohn’s disease: a national snapshot study

Celentano¹,

Pellino²,

Rottoli³

et al. 2020

Langenbecks Arch Surg

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“…They also highlighted the importance of the surgical technique and the fact that it was crucial to spare the nerve plexi within the pre-sacral region. 30 In contrast, Harnoy et al 31 observed worsening of sexual function in up to 50% of women, while erectile dysfunction was identified in 25% of men after RP with IPAA. In our study, half of the patients stated that they suffered from sexual dysfunction.…”

Section: Discussionmentioning

confidence: 96%

“…These outcomes were found to be acceptable and in agreement with prior studies. 29 Gklavas et al 30 reported that proctocolectomy in patients with inflammatory bowel disease caused no adverse effects on sexual function. These authors highlighted that all surgery in their report had been performed by an experienced colorectal surgeon.…”

Section: Discussionmentioning

confidence: 99%

Functional and Clinical Results of Patients Who Underwent an Ileal Pouch-anal Anastomosis

Yavuz¹,

Göbüt²,

Kubat³

et al. 2021

tjcd

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“…Despite the lack of evidence in this field, the literature identifies high levels of sexual disability identified among both male and female IBD patients, with just over half indicating that their IBD had a negative effect on their relationship status [ 30 ]. Both males and females tend to be more affected by surgery, especially after a proctectomy [ 31 ]. Just over half of the respondents said their libido had diminished, and this was true for both CD and UC patients [ 32 ].…”

Section: Sexualitymentioning

confidence: 99%

Inflammatory Bowel Disease Nurse—Practical Messages

et al. 2021

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Background and Objectives: Patients affected by inflammatory bowel diseases (IBDs) are complex patients with various problems from a clinical and psychological point of view. This complexity must be addressed by a multidisciplinary team, and an inflammatory bowel disease nurse can be the ideal professional figure to create a link between doctor and patient. The objective of this comprehensive review is to describe the figure of inflammatory bowel disease nurses and the various benefits that their introduction into a multidisciplinary team can bring, as well as a focus on how to become an inflammatory bowel disease nurse. Materials and Methods: A search on the PubMed database was performed by associating the terms “IBD” or “inflammatory bowel disease” with the Boolean term AND to the various issues addressed: “life impact”, “communication”, “fistulas”, “ostomy”, “diet”, “incontinence”, “sexuality”, “parenthood”, “fatigue”, “pain management”, and “follow up appointments”. Regarding the analysis of the benefits that the IBD nurse brings, the terms “IBD”, “inflammatory bowel diseases”, “Crohn’s disease”, and “ulcerative colitis” were used, associating them with the terms “benefit”, “costs”, “team”, and “patients”. Finally, regarding the focus on how to become an IBD nurse, an IBD nurse was interviewed. Results: An IBD nurse is a valuable nursing figure within the multidisciplinary team that takes care of patients with IBD because this nurse performs important functions from both a clinical assistance point of view (management of fistulas, ostomies, infusion of biological drugs) and an information and therapeutic education point of view (communication with patients, direct contact with patients by telephone or email). Furthermore, this nurse performs the “filter” function between doctor and patient, saving time for doctors that will be used for more outpatient visits. Conclusions: The introduction of an inflammatory bowel disease nurse is therefore recommended for multidisciplinary organizations dealing with the clinical course of patients suffering from IBD.

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Sexual function after proctectomy in patients with inflammatory bowel disease: A prospective study

Cited by 20 publications

References 36 publications

Surgical treatment of colonic Crohn’s disease: a national snapshot study

Surgical treatment of colonic Crohn’s disease: a national snapshot study

Functional and Clinical Results of Patients Who Underwent an Ileal Pouch-anal Anastomosis

Inflammatory Bowel Disease Nurse—Practical Messages

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