I've had a k-pouch for 42 years with about 4 revisions, 3 of them were due to more severe forms of gas escaping, then leakage and then nipple valve prolapse. I didn't have any issues for 25 years but like with anything, things can wear out. If I hadn't been working at the time and all I had was gas, which was horribly embarrassing, I imagine a few of my revisions could have been avoided. Now that I'm retired and have occasional gas, it still freaks me out but I can always figure out what it was I ate or drank and now intubate more frequently. I still would go through more revisions if needed to in order to keep my pouch. The doc I've had do my revisions through the years is Dr. Worsey at Scripps Hospital in San Diego.