Male Gender Is Associated with a High Risk for Chronic Antibiotic-Refractory Pouchitis and Ileal Pouch Anastomotic Sinus

Background and Aims The impact of gender on the development of chronic ileal pouch disorders following ileal pouch-anal anastomosis (IPAA) has not been evaluated. This study was aimed to assess the association between gender and pouch outcomes. Methods Comparisons of long-term pouch outcomes between...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2016-03, Vol.20 (3), p.631-639
Main Authors: Wu, Xian-rui, Ashburn, Jean, Remzi, Feza H, Li, Yi, Fass, Hagar, Shen, Bo
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anti-Bacterial Agents
Antibiotics
Chronic Disease
Colonic Pouches - adverse effects
Female
Females
Gastroenterology
Gender
Humans
Inflammatory bowel disease
Inflammatory Bowel Diseases - surgery
Male
Males
Medicine
Medicine & Public Health
Middle Aged
Multivariate Analysis
Original Article
Pouchitis - diagnosis
Pouchitis - etiology
Pouchitis - therapy
Proctocolectomy, Restorative - adverse effects
Review boards
Risk Factors
Sex Factors
Sinuses
Surgery
Surgical anastomosis
Young Adult
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Summary:Background and Aims The impact of gender on the development of chronic ileal pouch disorders following ileal pouch-anal anastomosis (IPAA) has not been evaluated. This study was aimed to assess the association between gender and pouch outcomes. Methods Comparisons of long-term pouch outcomes between male and female patients were performed using both univariate and multivariate analyses. Results Of all patients enrolled ( n  = 1564), 881(56.3 %) were males. Male patients were older at the time of inflammatory bowel disease (IBD) diagnosis and pouch construction. The frequencies of neoplasia as the indication for colectomy and significant comorbidity were higher in males, while fewer male patients had IBD-related extra-intestinal manifestations or concurrent autoimmune disorders. There was no significant difference between the genders in other clinicopathological characteristics. More male patients ( n  = 144, 16.3 %) developed chronic antibiotic-refractory pouchitis (CARP) than females ( n  = 73, 10.7 %) ( P  = 0.001). Seventy-four males (8.4 %) had ileal pouch anastomotic sinus versus 22 female patients (3.2 %) ( P  
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-015-2976-z