Anal and ileal pouch manometric measurements before ileostomy closure are related to functional outcome after ileal pouch—anal anastomosis

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Abstract
Anal canal length, anal canal resting and squeeze pressures, ileal pouch capacity and pouch compliance were measured in 104 patients after ileal pouch—anal anastomosis but before ileostomy closure. The intention was to determine if such parameters were associated with late functional outcome after re-establishment of intestinal continuity. Functional outcome in terms of stool frequency (day and night), incontinence (day and night), perianal pad use, perianal skin irritation, and the use of constipating agents was assessed for all 104 patients 1 year or more (median 438 days) after ileostomy closure. A low mean anal sphincter resting pressure before ileostomy closure was associated with subsequent nocturnal incontinence (P < 0·05) and, to a lesser extent, the need to use constipating agents (P = 0·08). Pouch compliance if low before ileostomy closure was associated with an increased frequency of nocturnal stool frequency after 1 year (P < 0·05). Anal canal length, anal sphincter squeeze pressure and pouch capacity before ileostomy closure were not related to subsequent functional outcome in these patients.