ABSTRACT
OBJECTIVES: Restorative proctocolectomy with ileoanal anastomosis (IPAA) is the surgical standard for patients with ulcerative colitis (UC). Significant reduction in female fertility and fecundity after IPAA has been shown in recent studies. In selected cases, colectomy with ileorectal anastomosis (IRA) is another surgical option. The aim of this study was to evaluate fertility in women with UC who underwent IRA. PATIENTS AND METHODS: This study included all women with UC who underwent IRA between 1962 and 1999 and who were 40 years old or younger at the time of surgery, and older than 18 years of age at the time of the interview. Data were collected using a structured telephone interview concerning reproductive behavior and waiting times to pregnancy. RESULTS: Among 40 eligible patients, 37 whose mean age at IRA was 28 years (range 11-39) answered the questionnaire. Twenty-two were unmarried, not wishful of pregnancy and/or already had children. Among 15 females wishing children after IRA, 10 (66%) became pregnant: one had therapeutic abortion, two had a miscarriage, four had 1 child, two had 2 children and one had 4 children. Five patients were sterile after IRA. CONCLUSION: These preliminary results suggest that IRA for UC preserves female fertility. If confirmed in other series this information should be provided to young women with UC before deciding surgical option.
Subject(s)
Colectomy/methods , Colitis, Ulcerative/surgery , Fertility , Ileum/surgery , Rectum/surgery , Adult , Anastomosis, Surgical , Female , Follow-Up Studies , Humans , Infertility, Female/prevention & control , Pregnancy , Pregnancy OutcomeABSTRACT
We report the case of a 65-Year-old man with advanced hepatocellular carcinoma related to alcoholic cirrhosis who was hospitalised for oliguric renal failure. Investigations showed a severe nephrotic syndrome related to paraneoplastic membranous glomerulonephritis. The patient's course was temporarily stabilized with loop diuretics and dialysis but the patient died of hemoperitoneum from a ruptured tumor.
