Sexual Distress Is Common in Long Term Follow-up After Pelvic Pouch for Ulcerative Colitis: A Cross-Sectional Study
Garrett Johnson, Tae L. Hart, Mantaj S. Brar, Selina Schmocker, Amandeep Pooni, Jordyn Vernon, Erin KennedyBACKGROUND:
Sexual dysfunction is common following pelvic pouch surgery for ulcerative colitis. Despite this, little work has been done to explore the degree of sexual distress this causes in patients.
OBJECTIVE:
To determine the proportion of patients with ulcerative colitis who experience sexual distress following pelvic pouch surgery and to explore the effects of social demographics, age, bowel function, anxiety, and depression on sexual distress.
DESIGN:
A cross-sectional survey that was emailed to patients.
SETTINGS:
A large tertiary care teaching hospital.
PATIENTS:
Patients who underwent pelvic pouch surgery for ulcerative colitis from 1980-2022.
INTERVENTIONS:
Validated questionnaires included the 13-item Sexual Distress Scale, Hospital Anxiety and Depression Scale, and Colorectal Functional Outcome questionnaire.
MAIN OUTCOME MEASURES:
The primary outcome was the proportion of patients meeting established thresholds for sexual distress. Multivariable regression was used to evaluate associations between sexual distress and operative factors, age, sex, income, education, ethnicity, sexual orientation, and relationship status.
RESULTS:
Of 1830 eligible patients, 497 responded and were included in the analysis. Overall, 194 patients (39%) screened positive for sexual distress. Women were disproportionately affected, with more than half reporting clinically significant distress (141/243, 57.8%). Female gender was the only independent preoperative predictor of sexual distress on multivariable analysis (odds ratio = 4.796, 95% CI: 3.119, 7.374,
LIMITATIONS:
Cross-sectional design limits causal inference. Selection and response bias are possible.
CONCLUSIONS:
Sexual distress is common following pelvic pouch surgery for ulcerative colitis, particularly among women, and is strongly associated with bowel dysfunction, anxiety, and depression. These findings highlight the importance of holistic pre- and postoperative counselling and consideration of psychological screening in follow-up care. Further research is needed to elucidate underlying mechanisms and develop targeted interventions. See Video