Continence alterations after ileal pouch-anal anastomosis do not diminish quality of life

PURPOSE: This study was conducted to compare continence after double-stapled ileal pouch-anal anastomosis and laparoscopic cholecystectomy using the Fecal Incontinence Severity Index and to assess the impact on quality of life using the Fecal Incontinence Quality of Life Scale. METHODS: Fifty-five patients randomly selected from a prospective pelvic pouch database were matched with regard to age and gender with patients who had undergone laparoscopic cholecystectomy during the same time interval by the same surgeon. Patients were mailed the two questionnaires, which were reviewed by an independent observer. Demographics, duration since surgery, and functional results were recorded. The Fecal Incontinence Severity Index and Fecal Incontinence Quality of Life scores were compared by the analysis of variance method. RESULTS: Fifty-one pelvic pouch and 50 laparoscopic cholecystectomy patients were able to be contacted and completed both of the measuring tools. For the pouch patients, the median number of bowel movements per day was six (range, 2-15), with two patients reporting more than occasional nighttime incontinence. Mean incontinence scores were higher for the pelvic pouch patients than for the laparoscopic cholecystectomy patients (17.8 vs. 10.7; P = 0.03). However, the quality-of life scores were very similar: lifestyle (3.8 vs. 3.83; P 0.88), depression/self-perception (3-81 vs. 3.83; P = 0.94), embarrassment (3.76 vs. 3.8; P = 0.84), and behavior/ coping (3.57 vs. 3.71; P = 0.5). CONCLUSION: Although continence is clearly altered after pelvic pouch surgery, quality of life is extremely well preserved.