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Hello,  I am considering getting a KP instead of an Ileostomy.  I have already had a total colectomy and my rectum does not function correctly.  I had a rectopexy but it didn’t help.  I am just wondering if I get a JP will my rectum need to be removed or is it optional? And if it’s optional I recognize that having it removed would take away all possibilities of colon cancer but are there any other benefits or problems with having it removed? For example one colerectal surgeon said there was a possibility of urinary and/or sexual dysfunction.  Has anyone experienced this?  I realize it’s a private topic but I don’t know where else to get a balanced opinion! Thank you in advance.

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The jpouch is designed to replace the rectum, then you make do without the colon. 

The advice and best practice is to remove as much of the colon and rectum as possible.  I specifically asked the surgeon about keeping the rectum (I figured with it I could pass gas easier which would alleviate a lot of the pain experienced by jpouchers, he said he could but that he strongly recommended against it.

 

I followed his advice.   This advice is pretty much universal from what I canc tell and you will see lots of people talking about the rectal cuff.  Basically depending on your build they cut as much out as possible.  I'm quite thin so it was easier on me, larger build people will have some cuff left but nowhere near enough to be functional, and can be prone to further issues.

I dont think they give you an option to keep the rectum atleast I wasnt given any. My surgeon told colitis has a very chance of flaring up in the rectum so its best to remove most of it. Its not worth having another surgery in future if the rectum developes ulcers. The pouch is a substitute for the functions of rectum.

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