Fifty-three studies were included (14,966 participants) with a median sample size of 127 (range 50 to 2,491). Most studies (70%) were retrospective cohort studies. Median duration of study follow-up was 75 months (range six to 180).
Pooled incidence rates for primary outcomes were: pouch failure 4.3% (95% CI 3.5 to 5.3; 43 studies), pelvic sepsis 7.5% (95% CI 6.1 to 9.1; 46 studies) and severe daytime faecal incontinence 6.1% (95% CI 2.9 to 12.3; 13 studies). In sensitivity analysis, pouch failure rate was 4.7% in studies with at least five years' follow-up.
Pooled incidence rates for secondary outcomes were: fistula 4.5% (95% CI 3.5 to 5.7; 38 studies), stricture 10.7% (95% CI 8.2% to 13.8; 35 studies), pouchitis 26.8% (95% CI 21.0 to 33.5; 39 studies), sexual dysfunction 3.0% (95% CI 1.7 to 5.2; 13 studies), small bowel obstruction 11.4% (95% CI 9.1 to 14.1; 34 studies), mild daytime faecal incontinence 14.3% (95% CI 7.3 to 25.9; 21 studies), mild night-time incontinence 17.3% (95% CI 4.7 to 46.8; nine studies), severe night-time incontinence 7.6% (2.5 to 21.3; 10 studies), daytime faecal frequency 5.7% (95% CI 4.9 to 6.7; 26 studies), night-time frequency 1.5% (95% CI 1.0 to 2.1; 22 studies) and 24-hour frequency 5.9% (95% CI 5.0 to 6.9; 26 studies).
The review also reported how these estimates of incidence compared with the findings of a systematic review of 43 studies conducted prior to 2000 (see Other Publications of Related Interest).