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

Author

Functional outcome

Bowel frequency

Night 24h"

Night stools

Incontinence

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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