Functional Outcome

The studies reporting on functional outcome including bowel frequency (number of motions during the day, night, or over a 24-h period), need for night defecation, incontinence (during day, night, or 24-h period), faecal urgency (inability to hold stool for more than 15 min), incontinence pad requirement, and the need for anti-diarrhoeal medication (Table 5). Figures 5 and 6 shows the results from meta-analysis of these outcomes and are depicted as a Forrest plot.

Results significantly favouring IRA over IPAA included: reduced bowel frequency of 2-6.1 per 24 h vs. 3.8-8 per 24 h (WMD=1.62, 95% CI 1.05-2.20), reduced need for night defecation of 8.2 vs. 44.1% (OR=6.64, CI 2.99-14.74), reduced incontinence during the night of 3.8 vs. 21% (OR=8.03, CI 4.22-15.25), reduced incontinence rate over a 24-h period 30 vs. 50.5% (OR=2.71, 95% CI 1.81-4.07), and reduced requirement for incontinence pad use during a 24-h period of 5.4 vs. 14.5% (OR=2.72, CI 1.02-7.23). The only functional outcome significantly favouring the IPAA group was faecal urgency, which was 39.2% with IRA vs. 14.2% following IPAA (OR=0.43, CI 0.23-0.80). There was no significant difference between IPAA and IRA groups in bowel frequency at night, daytime incontinence, and need for anti-diar-rhoeal medication.

Fig. 4. Meta-analysis of sexual dysfunction

Table 5. Studies reporting functional outcome with IPAA vs. IRA


Functional outcome

Bowel frequency

Night 24h"

Night stools


Faecal urgency

Pad use

Day Night

Anti-diarrhoeal medication

Ambrose [2] Bjork [31] Gunther [37] Ko [41] Madden [35] Penna [35] Rodriguez [42] Rotondano [43] Soravia [20, 24] Tonelli [14] Van

Duijvendijk [44] Ziv[13]

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