Conclusions

Urologie and sexual problems in patients with IBD are not rare and ean be either the consequence of the evolution of the inflammatory process or the consequence of its treatment. Males and patients with Crohn's disease are the most exposed.

Early urinary symptoms are often missed both by the patient and doctor because they are not specific and are overshadowed by the more severe intestinal manifestations. When they become evident, renal damage may have already occurred. For these reasons people with IBD should be periodically examined with simple exams such as urinalysis, serum cre-atinine level and abdominal ultrasound in order to recognise these manifestation at an early stage and carry out the appropriate treatment. Some conditions can be prevented or treated with diet or medicines, while others, like fistulas and obstructive uropathy per se indicate an advanced intestinal disease which usually requires surgery.

Sexual alterations are quite troublesome, especially because of the young age of these patients. Again, it is very important that doctors dealing with IBD are aware of the possibility of sexual problems and investigate them appropriately. Often, counselling with a specialist is sufficient for ameliorating the situation; as psychological factors may play a major role in causing dysfunction, the patient should be reassured that a correct treatment of the inflammatory disease usually results in significant improvement not only in general conditions but also in the social and sexual life.

On the other hand, patients should be informed that surgical treatment, especially in the case of rectal resection, carries the potential risk of urinary and sexual complications that in a minority of cases are permanent and may significantly affect the quality of life.

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