Some women may experience increased fertility due to removal of the inflamed colon. Unfortunately, others may have decreased fertility from adhesions or scar tissue that develop after the removal of the rectum. Additionally, with pregnancy, the method of delivery remains controversial (C-section versus a vaginal delivery), because any injury to the anal sphincter (control) muscles may lead to the inability to control the stool. It is important to inform your obstetrician of the changes in your anatomy as a result of the pouch so he/she can perform a C-section should any problems arise during the vaginal delivery.
Impotency and retrograde ejaculation (the sperm going into the bladder instead of out the end of the penis with ejaculation) are serious but relatively rare occurrences. It is essential that your surgeon be aware of any difficulties with intercourse following pelvic pouch surgery.