Late outcomes of J-pouch in patients after proctocolectomy for ulcerative colitis

AIM: to assess late functional outcomes and quality of life of restorative proctocolectomy with J-pouch in patients with ulcerative colitis.

PATIENTS AND METHODS: the retrospective study included 76 patients operated in 2013–2018. Quality of life and continence were assessed using the SF-36 questionnaire and the Wexner incontinence scale. The first survey was done in 2018–2019, and the second one — in 2025. Complete paired data were obtained from 49 (64.5%) patients. Paired comparisons between the two surveys were performed using the Wilcoxon signed-rank test. Associations between QoL and continence function were analyzed using multiple linear regression.

RESULTS: a significant decrease was detected in several SF-36 domains: general health (GH) 67 (50; 82) vs 57 (47; 75), p = 0.028; vitality (VT) 67 (50; 82) vs 57 (47; 75), p = 0.0008; mental health (MH) 72 (60; 86) vs 64 (52; 74), p = 0.013; and in the mental component summary (MCS) 51.1 (40.5; 55.1) vs 45.3 (38.7; 51), p = 0.013. No significant differences were found in the remaining domains. A marked increase in incontinence symptoms was noted over time: the median Wexner score increased from 1 (0; 2) to 4 (1; 10.5), p < 0.0001. However, no significant association was found between deterioration of continence and quality of life according to regression analysis. Female gender was identified as an independent predictor of lower QoL (p = 0,046).

CONCLUSION: over time, patients with a J-pouch demonstrated a significant decline in continence function and quality of life due to worse psychoemotional domains, while physical components remained relatively stable. No significant correlation was found between QoL and continence impairment.

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