Sexual function and perineal wound healing after intersphincteric excision of the rectum for inflammatory bowel disease

Abstract

The technique of intersphincteric excision of the rectum in patients with inflammatory bowel disease was introduced with the aim of avoiding postoperative sexual dysfunction and, combined with primary perineal suture, should decrease morbidity from delayed perineal wound healing. In a series of 98 patients so treated at St. Mark's Hospital, permanent sexual dysfunction from sympathetic nerve damage occurred in one male patient among 23 aged 60 years or less assessed postoperatively. No patient exhibited evidence of permanent parasympathetic nerve damage. Primary healing of the perineal wound was successful in 50 per cent of the cases and in 69 per cent the wound healed within three months of operation. It is suggested that this combination of operative techniques significantly decreases morbidity from rectal excision compared with more extensive procedures and should be more widely adopted.