Surgery and Impotence

Hi all,

Well, my fiance is having the surgery. His specialist recommended it last Thursday, as his body has not responded to any treatments or medicines. He's really, really struggling with his disease, as I'm sure many of you are. He emailed me from work this morning to let me know that he didn't make it to the washroom on the drive in, and that he brought a change of pants but no extra shirt (I guess this was a really bad accident). He said he's going to stay in his seat all day so no one sees him. I hate seeing him so down.

He's actually very excited to have the surgery, but both of us have some concerns...mainly about a point that I haven't seen brought up at all (it may be buried in the many threads), which is surgery and impotence. My fiance's original doctor was very against the idea of surgery and said it would be a last resort (which we're now at). He said he was worried because some male patients are rendered impotent by the surgery. This is obviously an uncomfortable topic to bring up, and yet it is an important one. We're a 25-year-old couple and we're getting married in four months, so this is certainly a worry.

Any help you can provide on this topic, or about surgery in general would be fantastic.

Thanks everyone!

I think the key is to have the surgery done by a colorectral surgeon with lots of experience doing this type of surgery. You don't want a general surgeon doing it.

Does he have a surgeon in mind already? The people on this board and at the j-pouch site could give some recommendations if not.

I'm not a guy, but I'm in the process of getting my Jpouch and from what the literature I've been give says as well as what I've read on Jpouch.org and other sites, the main thing to be concerned with when it comes to impotence is keeping the sphincter intact. That muscle is what helps keep the erection, well, erect. If he is Jpouch surgery he should most definitely look for a specialist in that area, even if he has to travel out of state. Ileostomies are preformed in many places very well, but if the rectum is removed which in the case of UC it should be, than once again you want a specialist who is well known and will preform what is called a sphincter saving surgery. They will either remove or strip the rectum and that is the tricky part. My surgeon strips the rectum for Jpouchers leaving almost or no rectum muscle at all so she is very skilled at saving sphincters. I live in Cincinnati, but if I had not known about her Cleveland Clinic would have been my next choice.

BTW, the surgery is so life changing, for the better! I wish i hadn't been so afraid to get it and had gotten 3 years ago when I was first told that I needed it. I feel wonderful with my ostomy and have no doubt that after my initial adjustment I will also feel wonderful with my Jpouch. Best of luck to him and you! Come see us at the Ostomy part of this board if you ever have questions about the surgery or life after. :)

i had my colon removed (UC) feb-2011 and had my loop closed april-2011, have been using j pouch ever since.
i had the surgery because there was no other options that didnt involve prednisone, i didnt want to...
i was promised by a surgeon with almost 20 years experiance that he had never had a case where sexual function was an issue.
i must be the first...
i do not suffer from depression or anxiety and i have almost no sexual thoughts and zero physical sexual response.
my point is as follows...
when the rectum is disturbed there is no telling what the bodies response will be. you must keep in mind that when a healthy male has sex the rectal area is and must remain empty for the nerves and muscles to perform. having a j-pouch alone is contradictory to that in that there is for lack of a better term "stool" always in that area.
this is not to tell someone not to have the procedure, if its necessary then its necessary, just beware that your body will never be the same.

We were told by our surgeon that during the colectomy the possibility is negligible. However during the attachment of a J pouch they need to work very close to the nerves that travel to the penis. Our surgeon said that, in her hands, there is about a 1% chance of some sort of sexual impairment that is usually temporary. The possibility of permanent damage is lower than that but it does exist. You should get numbers from the surgeon that you are thinking of using.

I'm no expert, but another thing to consider is damage to testicles or ovaries from the Xrays or CT scan done to verify the integrity of the jpouch before
takedown. You may be risking dna damage to
your future children. CT scan is much worse.
http://www.time.com/time/health/article/0,8599,1818520,00.html
The technicians don't attempt
to shield reproductive organs from the radiation since these organs are apparently too close to the jpouch.

First I'd try fecal transplant. First with no antibiotics.
Then, if that doesn't work, do triple antibiotic therapy followed immediately
by fecal transplant.
https://www.healingwell.com/community/default.aspx?f=38&m=2088679
As his fiancee, you'd probably make a good stool donor. Some
UC patients report improvement with diets such as Specific Carbohydrate Diet.

It very very rare that guys who have surgery for UC or Crohns suffer impotence from it. It's more likely to occur if the surgery is for cancer since the surgeon has to cut deeper to try and make sure they get all the cancer out.

The 'good' news is that IF it does happen, it's usually only temporary and as the weeks go on everything will return to normal. For those whom it doesn't, quite a few of my guy friends have said Viagra is a big help :)