Hi Sallyap. I got my jpouch 30 years ago. It served me pretty well during that time. However over the last 3 years I developed severe branching fistulas/ abscesses, super painful. I decided to have an ileostomy (surgery Nov19). Interestingly even though my GI said it wouldn’t happen, all my fistulas and abscesses are healed. I’m not currently contemplating reattaching the jpouch as I think it would all become problematic again but it’s great to have all the pain gone. I also may not need to remove the (now retired) jpouch ( ie avoid the full Barbie Butt surgery) which would make me happy as I think that’s pretty major surgery. I did try setons but they didn’t do a lot for me and were super uncomfortable. Good luck in exploring your options. I hope things improve whatever path you choose.