I need advice from anyone who has had a problematic jpouch or anal stricture. I’ve had my pouch 7 years this May with a lot of issues mainly due to a stricture at my anastomoses and chronic cuffitis.
I went in for a scheduled analplasty due to stricture at anastomoses yesterday. The plan was to excise one side of scar tissue in cuff and drop that side of pouch and hand sew it. I also have pretty severe anal fissures over the last year or so where creams are not helping heal them.
The surgeon was unable to do anything but biopsy and dilate yesterday due to the level of inflammation esp posteriorly and due to inflammation/ulceration in cuff.
He’s recommending a three month ostomy w excising rectal cuff and advancing pouch as well as pulling skin up from lower anal canal at same time. I’m guessing the latter is to heal the fissures?
I was so drugged out after the procedure that I don’t remember all the conversation but he drew my husband a picture and I also have mild to moderate inflammation in pouch w ulcers in a few spots. I’m on no antibiotics or meds for this and have not been for a long time. On occasion i suffer from pouchitis symptoms but they often resolve in a day or two or if not I’ll pulse antibiotics for a few days.
I honestly feel I could live with my pouch ( hell I have been struggling with it for years to hold on to it ) if the surgeon could correct my stricture and fissures, but I’m very concerned about going through two more surgeries with what appears to be a less than optimal pouch to begin with.
My prior consult w Remzi resulted in a recommendation for complete pouch redo. Dr Milsom is the surgeon I had my procedure done with yesterday and he also did my original jpouch surgery.
I am really struggling with going through another abdominal surgery and ostomy if this procedure might fail and if it does my bigger concern is if am I no longer a candidate for a complete pouch redo?
I am making my list of questions for my surgeon. I can imagine a surgeon hates to throw in the towel on a surgery they originally did w the recommendation of a pouch redo.
I always have chronic mild to moderate inflammation in my pouch and cuff and last time ulcers were only seen on suture lines in the pouch, but the finding of new ulcers near the pouch inlet was news to me yesterday. I also have some ulcers in distal pouch and the cuff is a mess. The area above pouch always looks good.
I guess I’m just looking for any advice if anyone has been down this road. I know only I can only make the final decision to try this but my biggest concern is if it does not work that I’ve lost any opportunity for a pouch redo with possibly a healthier jpouch this time around.
I’ve been fighting a permanent ostomy for a long time and wonder if at 55 if this is the smartest way to go. I’m tired of drugs, insane medical bills and the rollar coaster of chronic illness. I know this is a less invasive procedure than a complete pouch redo but I wonder if I’m just delaying the inevitable with more surgery to eventually create a permanent ostomy.
I’m sorry for this long post. Any advice would be appreciated