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About 10% of patients with ileal pouch anal anastomosis (IPAA) end up with pouch failure. Health related quality of life (HQoL) for failures are worse compared to functioning IPAA:s. Reports on sexual function and IPAA are conflicting and not studied for failures. Our hypothesis was that pouch failure leads to a deteriorated sexual function.Fifty-four (28 women)/593 IPAA in Gothenburg have had pouch failure. Fifty-one were accessible for follow-up. Sexual function was examined by questionnaires; international index of erectile dysfunction (IIED) for men (5-75; sexual dysfunction < 42.9) and female sexual function index (FSFI) for women (2-36; sexual dysfunction < 26.55). Controls: age and gender matched population with functioning pouches (n = 72).36/51 of patients with failure answered, 24 (13 women) were sexually active. 60/72 (34 women) controls were sexually active. FSFI scores (median); failures: 28.2, controls: 29.8. IIEF scores (median); failures: 60.0, controls: 64.5. Forty-six percent of the female and 45% of the male failure patients had a summary score below the cut of for sexual dysfunction. Results for controls were 21% (women) and 19% (men). The differences were not statistically significant.The hypothesis, that a failed IPAA is associated with impaired sexual function was not confirmed.