In my case, ED resulted from my original j pouch surgery. The use of a medication (Viagra) has produced satisfactory results for me. Removal of my J pouch many years later produced no additional nerve damage, although the surgery was challenging. At the time my J pouch was removed, my surgeon in Florida created a BCIR (similar to a K pouch). I strongly did not want a permanent ileostomy with its associated issues, particularly relating to intimacy. The surgery went very well and I now enjoy a very good quality of life. The button-hole size stoma is located below the belt line and no external bag is required. I mention these options as something you may want to consider, but selection of a procedure is a personal matter best made after doing your research and consulting with your doctor.
The BCIR procedure was recently approved in the UK and is being performed by Dr. Ed Westcott in London. He was trained by my surgeon, Dr. Ernest Rehnke in St. Petersburg, Florida, who has done well over 1,000 of these procedures.
Bill