Restorative Proctocolectomy with Ileal Pouch Anal Anastomosis and Womens Health

The restorative proctocolectomy with IPAA (RP-IPAA) is now a standard operation proposed for the treatment of UC. It is a complex operation requiring an expert surgical team. Despite the fact that it is generally performed in third-level centres only, complication rate is extremely high, varying in the studies reported in the literature between 13% and 64% [37-39]. Indications for this procedure are different in emergency or elective surgery: toxic megacolon, perforation or massive bleeding (in emergency surgery] or failure of medical therapy and rectal dyspha-sia/cancer (in elective surgery]. The operation greatly modifies the anatomy of the pelvic space because, after resection of the entire colon and rectum, an ileal reservoir (pouch] is engaged in the top of the anal canal. Since 1978, the year of the first formal description of the operation, many women of child-bearing age have undergone this operation. In the last 20 years, many studies have been published attempting to analyse two aspects: how this operation may influence female reproductive health and whether pregnancy affects functionality of the ileal pouch.

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