My thoughts are to do everything to keep your J pouch and Cleveland Clinic is an excellent place to help you. I had a J pouch for 30 years and recurrent high grade dysplasia and a malignant polyp in the anal canal that made pouch removal necessary. I strongly did not want an ileostomy with its associated issues and was able to get a continent ileostomy, They do the K pouch procedure at the Cleceland Clinic and you can inquire about it while there, I have had my BCIR (very similar to the K pouch) for 9 years and it has given me a very good quality of life. Please feel free to message me. Bill