My wife had her 1st J-pouch for ~2.5 years and basically her rectal cuff still had UC and was a chronic problem, things never seemed to function correctly for her and nothing would seem to calm it down. She was diverted 1.5 years ago and eventually had a “pouch advancement surgery” with a mucosectomy last July. There were major complications when creating her new jpouch as her SM artery wasn’t long enough to connect her pouch (a separate topic) but with another surgery in between she recently had her ileostomy reversal. Yes as stated above everything was hand sewn and they did perform tests to make sure her muscle strength was adequate for control before continuing. This whole process has been a lot harder on her and recoveries took longer with these surgeries compared to the surgeries for her 1st jpouch but she was adamant about giving a jpouch one more try. It’s still too early to tell if things are functioning better for her this time around but we are hopeful.