Got my pouch in 2003. Had my prostate surgically removed 01/2021. Dr. Bo Shen at Columbia Presbyterian NYC is following my pouch. Prior to surgery I consulted with radiology/freezing/surgery. The consensus was surgery. Dr. Joel Decastro was my surgeon. He had prior experience with pouch patients. Very pleased with him. A couple months later I started having incomplete emptying and pouchitis. Defocagraphy and manometry determined my pouch had lost the support that my prostate provided to the pouch. My pouch was also twisting when emptying. Citroen covered the pouchitis. Dr. Shen placed rubber bands in my pouch to expand it, and create scar tissue inside. The purpose was to create scar tissue inside and stiffen the pouch. The bands come out while defecating. Was also prescribed bio feedback physical therapy to retrain my pouch to work properly with my anus. Early in the PT but I have seen some relief. In the middle of all that i learned I had a bacterial infection from yersinia. Most often caused by consuming undercooked pork. Symptoms resembled pouchitis. Still, I am glad I had my prostate removed. Best of luck.