Does intramesorectal excision for ulcerative colitis impact bowel and sexual function when compared with total mesorectal excision?

Methods: We compared patient-reported bowel and sexual function among IME versus TME UC patients (September 2000 to March 2011) using the Memorial Sloan-Kettering Cancer Center Bowel Function scale, Fecal Incontinence Quality of Life, Fecal Incontinence Severity Index, Female Sexual Function Instrument, and International Index of Erectile Dysfunction surveys

Background Proctectomy for ulcerative colitis (UC) can be performed via intramesorectal (IME) or total mesorectal excision (TME)

Results: Eighty-nine IME versus TME patients (35 ± 2 years, 57% male, 62% IME) had similar baseline characteristics, although IME patients had more open procedures (P ≥.03). IME patients reported better fecal continence (P =.009) but similar fecal incontinence-related quality of life (P ≤.44). For sexual function, there were no differences for either women (Female Sexual Function Instrument; P ≤.20) or men (International Index of Erectile Dysfunction; P ≤.22)

Conclusions: IME appears to be associated with better fecal continence but no difference in overall bowel or sexual function compared with TME in patients with UC.