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Very Bad Stricture, please need Advice, Needle Knife, Balloon, or Dilators?

I have Anal Stricture at the bottom of the J-Pouch and it’s bad. Had a few Office Dilations and had been self-dilating, it was going well but hurt my back and couldn’t do it for a few months. Very hard to get the Mucus out. My last office dilation was about 51/2 years ago. My J-Pouch was diverted 5 years ago mostly because of this, so I have an ileostomy. Has anyone gone to Dr. Shen for his Stricturotomy (needle Knife} procedure or Balloon Therapy.

Or should I ask my doctor to try and open it up with different sized dilators (small to larger). I don’t know. It’s very tight and painful in there so maybe it’s time to remove the J-Pouch? I would appreciate any advice. Thanks.

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