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This study investigated long-term results in patients who had undergone restorativeproctocolectomy (RP) with ileal pouch anal anastomosis (IPAA) at young age because of ulcerative colitis or familial adenomateous polyposis.Medical records of 26 consecutive patients who underwent surgery at an age of 10 to 24 years between January 1992 and October 2008 were reviewed for operative characteristics and complications. Patients were surveyed to evaluate bowel function, quality of life (QoL), body image, cosmesis and sexual function (response rate: 88%).Median age at surgery was 18 years (range 12-23) and median follow-up was 12.5 years (range 2-18). Long-term complications occurred in 85% of patients including pelvic abscess, bowel obstruction and pouchitis in particular. Complications led to pouch excision in five patients. QoL scores were satisfactory. Females scored non-significantly lower than males on body image (P = 0.08) and cosmesis (P = 0.07). Men did not report impotence or retrograde ejaculation. Conversely, 50% of our women experienced sexual dysfunction.A relatively high complication rate was found. Diminished body image, cosmesis and female sexual function were objectified. This shows that RP with IPAA performed at young age can have a negative impact later in life. Surgeons should be aware of these consequences.