Ileal pouch anal anastomosis: an overview of surgery, recovery, and achieving postsurgical continence .

Ileal pouch anal anastomosis (IPAA) is a two- or three-stage surgical procedure performed to treat patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP). Following ileostomy closure and anastomosis, patient goals of care typically include obtaining continence and preventing complications. Nursing interventions to achieve these goals may include developing a skin care regimen, pelvic muscle floor exercises (PFME), diet changes, medication use and coping strategies. Research suggests that patient quality of life following surgery is generally good, especially in patients with a functioning pouch or a history of severe UC and a functioning pouch. However, the procedure is relatively new, and long-term (>20 years) outcomes remain largely unknown. Ongoing assessments to monitor complications such as pouchitis and pouch stricture are needed, as is research to determine the long-term effects of vaginal delivery and of living into the seventh, eighth, and ninth decades of life.