I certainly recommend treatments to get a J pouch working properly before considering removal. In my case, my J pouch had to be removed because of recurrent high grade dysplasia in the anal canal. I strongly did not want to get an ileostomy and opted for a BCIR, which is similar in most ways to the K pouch. The surgery involved removal of the J pouch and creation of the BCIR in one operation. I had a good recovery and was able to do many of the activities I enjoy two months after surgery. After my original surgery, I had partial ED, but removal of the J pouch did not make it any worse. With the BCIR, I am able to experience intimacy much better than if I had the bag. With whatever surgery you have, be sure to pick a surgeon who has done many of those procedures.