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Hello All - I am considering doing the Jpouch surgery in the near future and have the following question/concern:

Are there any males out there who have lost sexual function due to the Jpouch surgery? Is it something that you have heard of that has happened to someone who does the Jpouch surgery? I am 30 years old and want to have kids in the future. Thanks!
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One of the risks of surgery is that there is cutting in an area in which there are various nerves that control sexual function in males. 2% of males having surgery end up with permanent impotence and 10% with temporary impotence, based on what my surgeon told me. If you are single or want to have children in the future, you will be advised to bank your sperm. It will be prudent to do so, in the unlikely event that you fall into these very low percentages of persons rendered impotent by the surgery.

The surgery had no impact whatsoever on my own sexual functionality. I think my sexual functionality may have actually improved after J Pouch surgery, because I was not really sick any more.
Last edited by CTBarrister
Did not lose any function from mine. i was pretty worried about it myself, it wasnt that i read alot of it happening or anything its just thats one thing i really really really did not want to lose lol,
I dont necessarily know if my functionality improved per say..CTBarrister, do you find that you sweat more in the buttocks region? or maybe just in the beginning?

I tend to sweat a lot all over in the warmer weather, and need to drink copious amounts of fluids to stay hydrated. When I work out, I sweat a lot in the groin/buttocks area and I need to shower and keep this area very dry after workouts.

Like you, I was worried quite a bit about the possibility of impotence as this was a risk, albeit slight, that my surgeon prominently mentioned when we went over the informed consent issues. He strongly recommended I bank my sperm (I didn't). I had my J Pouch surgery done in 1992 and because everyone was scared crapless about AIDS at that time, I was actually affirmatively required by the hospital to donate a large amount of my own blood in the weeks prior to surgery (in case I needed a transfusion during surgery - and I think I did). Several years earlier, tennis legend Arthur Ashe had contracted, and later died of AIDS after receiving AIDS-tainted blood during a transfusion while undergoing heart surgery.

My recollection is that I had an erection very soon after my urinary catheter was removed and it was a great relief when that occurred. You might say it was the happiest erection of my life, although since I was in a hospital bed at the time, there was not much I could do with it. Big Grin
Last edited by CTBarrister
My husband lost his sexual function..however, with the aid of Viagra/shots etc, it helped. Plus, weightlifting has helped with his desire/libido (helps the testosterone levels). It was a hard decision(no pun intended) for him to have the surgery since that was one of the long lasting side effects from the surgery..but it saved his quality of life.
As I posted earlier the chances are 2% for permanent impotence and 10% for temporary impotence. They are slight risks but risks nonetheless.

There have been posts in the Men's Health Forum by those rendered permanently impotent and/or with serious retrograde ejaculation issues. Those threads/posts are there if you want to search them.

As I mentioned earlier banking one's sperm solves the reproduction issue. The issue boils down to the risk of losing sexual function or having it impaired.
There are a lot of medical articles out there, but not a lot that are current and specific to this surgery. It seems there is more data on similar surgery for low rectal cancer. This link is to a more comprehensive article about all complications, but discusses male sexual dysfunction too (I beleive they say the rate is 1%). As surgical technique cintues to improve and the use of laparoscopic surgery, these sorts of complications naturally improve. Complication rates will vary according to the center. So what is most important is YOUR surgeon's complication rates, not what you read in a study.

For women, it all depends on what you consider to be a sexual dysfunction complication. Some studies include infertility in the definition, and this is the major complication for women in the reproductive organ area. Infertility risk due to adhesions increases sharply (30-50%) depending on which study you look at. A small percentage develop pelvic nerve damage causing painful intercourse, which may or may not be permanent.

Jan Smiler
Also - where did you find this statistic?

As I said earlier in the thread they came from my surgeon's mouth, and he at the time (1992) was the best colorectal surgeon in the USA or had that reputation (and also did the 1st K Pouch surgery in the USA and studied in Sweden with Dr. Niels Koch). So I did not see fit to question any stats he quoted to me. The reputation Mount Sinai Medical Center has today, and had then, and the development of Drs. Bauer and Gorfine (his proteges) as go to colorectal surgeons in New York City is all because of him.

We only discussed male impotence (since I am a male) and the stats given to me were for males.

Jan is probably correct that surgical technique has improved since then but it is still a small risk in whatever % cases.
i can only speak on this from my perspective...
i have zero nerve damage and should have no issues but without daily supplementation of vit d and vit e, i am basically impotent. since taking vit d and later vit e i am able to perform at about 90% of what i could pre surgery but only once every 10 days or so.
that may not sounds like much to some but i was a solid twice a week guy with rock hard erections (no offense with my language intended). it is just my personal opinion but...i believe these figures provided to men are questionably low, i wonder how many men report issues and are shipped off to the urologist to find another "reason". just from a common sense thought process there is waste in an area where the rectum once was. that area is meant to be empty when a man engages in sexual activity. it is unreasonable to expect that there wont be least to some degree.
question surgeons, after all they're part salesman.

You are absolutely right about this. I did not question mine because he had the voice of a god and to me he was a god.

One other thing worth adding to the discussion is the impact of age and weight gain on erectile function. I sense a lot of you are younger guys who have not had the benefit of the experience of aging or putting on weight, yet. When you are in your 20s and can have 10 orgasms in a day, it is a wonderful thing. As you get older and/or put on weight, guess what, it will not be happening whether you have J Pouch surgery or not. After J Pouch surgery I had 14 stellar sexual years with no incidences of impotence while having sex when, in 2006, at age 43, and while having sex with a woman I had had sex with many times, I suddenly went limp in the middle of intercourse. It sucks, but I have news for you guys: it will happen no matter what. My partner thought it was her, but I knew immediately IT WAS ME. When you hit your mid 40s is when these things start to happen. Since that time I have learned that I can maximize the power of the engine by staying in good shape. There is zero one can do about the aging process. Anyway just something to think about for all the guys who admire their own sexual abilities.

By the ways, I have tried cialis, viagra and levitra, and levitra works best for me with no side effects (the other 2 gave me a dull headache). My issue, when I have an issue, is not getting an erection, but rather maintaining it for a period of time. That is what I have lost in the aging process. Levitra can definitely help with the maintaining of the erection, as opposed to the dreaded start up and stop.

I would most certainly bank sperm. I was a healthy thirty year old and had all in one J-Pouch surgery eight years ago. I do not regret the surgery, however, I produce no ejaculate and it seems no semen at all. I do however feel the same sensations during orgasm, so that's cool.

My wife is 17 weeks pregnant due to IVF and I owe it all to banking my goods. Do it to be safe.

i have zero nerve damage and should have no issues but without daily supplementation of vit d and vit e, i am basically impotent. since taking vit d and later vit e i am able to perform at about 90% of what i could pre surgery but only once every 10 days or so.
that may not sounds like much to some but i was a solid twice a week guy with rock hard erections (no offense with my language intended). it is just my personal opinion but...i believe these figures provided to men are questionably low, i wonder how many men report issues and are shipped off to the urologist to find another "reason"

I noticed things weren't quite the same after my surgeries, but I guess I thought it would just take time to get back to normal. My surgery was 4 years ago, and things haven't really improved. I wasn't sure if this was from having surgery or from getting older, but I'm 28 now and was only 24 when I had my surgeries. For a while I didn't think much about this because I was very depressed anyway and not sexually active, but it's starting to become a problem as I'm trying to become sexually active again.

I very much relate to what 5459 said above. I am able to get an erection, but I am far less responsive to stimuli than I was before surgery. I almost never get a full erection without a good amount of direct physical contact, and even then, it's a struggle to maintain it. I have wondered if this was simply due to the fact that without a colon, you get worn out more easily (which may be why vitamin supplements might help.) I've also wondered if this surgery can have an effect on testosterone levels. I remember before I had my surgeries I read a young guy's blog about his j-pouch and how getting testosterone and b-12 injections helped him a great deal with his mood and energy levels. Anybody have any thoughts or information or links regarding any of this? If I'm still able to get an erection, could it still be that there is some nerve damage?
Sexual disfunction for both guys and girls has a lot to do with what is going on in your head...although guys are a lot more visual than girls, you too can get psyched out due to anxiety and stress (a lot of us girls lose our desire due to stress of pouch leakage, image problems etc)...throw pouch surgery into the mix and even if no one has touched any nerves or other 'guy parts' you can walk away with problems...
Setting aside functional problems, I am sure that a lot of you suffer from performance anxiety due to 1 incident. If you try and fail the first time out you get stressed or panic the next time and it can become a cycle (not talking about the 'real' functional problems here)...when speaking with my doctors and a few of my clients (I am a coach) I found out that this a rather common problem for guys. My doc said to 'break the psycological cycle' is the only way to get past it for men...he prescribes a short run of a viagra-like med for no more than 3 goes (does not want the patient to become psycologically hooked on it believing that that is the only way to make it work). He says that it usually does the trick. Occasionally talk therapy helps too...
Don't forget that you guys depend a lot on your pelvic & abdominal muscles for things to work well and if you have atrophied or weak muscles you are going to have problems there too...start working on your keigels to reinforce those muscles even if you can not yet do crunches or other abs...
ps...and this is a girls opinion is supposed to be fun and not a serious go back to having fun, make it about pleasure and joy and less about performance...and things may just go back to normal on their own.
There is a basic algorithm for erectile dysfunction that will inevitably lead to a solution. It's not an easy road but doable. If you can get firm nocturnal erections the plumbing is working and gaining confidence is the goal. If that is not the case then there is a physical problem. Maybe your testosterone is low. If so, shots or gels might help. The problem is that taking testosterone on a regular basis negatively affects fertility. There are the pills, Viagra and Cialis. They work for some and not others. Some get intolerable side effects. The next step is injections into the penis. Again, that works for some and not for others and can lead to scarring. Another approach is vacuum pumps and a tight ring. Not romantic for most. Finally, there is the option of an inflatable penile prosthesis. It sounds drastic but a skilled surgeon can do it in half an hour and some will clear you for intercourse in three weeks. I went down this road and got there and can say I wish I did it ten years sooner. For a man, especially one who has struggled with ED, being able to get it up whenever and for however long is a life transformative event. Check out the videos of Edward Karpman on Youtube. He is my surgeon and a great guy!

For anyone suffering after the take down, please get with your urologist asap! Make an appointment and get the process going. It takes a patient partner and trying out what is going to work for you, and time is a healer and things should improve. Not every guy comes out of this J Pouch process with the best back to normal capabilities. You may have to find a new normal. It may be taking a pill, or something else that the doctor can recommend and YOU feel comfortable with....your penis is a muscle, when you do not exercise it, you lose functionality and it is up to you guys to get an action plan. Do not think that just time will be the only answer. I speak from experience, and I hope you all feel better. This is more than an ego topic, it is also the core of what some men or how some men base their well being in life, or quality of life. You do not have to suffer mentally over it is the point. If you don't have a urologist, get one, and I hope the best for you. Sincerely.

It has been a year after my surgery. I was never told of any possible side affects by any of the medical staff I came in contact with. 

About 5 or 6 months after I my j pouch surgery, I started to have painful erections that would even sometimes wake me up. This has dissipated but there has been little information I’ve been able to find in either articles or by asking my doctor(s). I’ve seen two urologists so far and made a call to the surgeon about this, who did not not completely sweep him under the bus, I admit to not following up on it.

Last month I was told that I had developed a case of Peyrones’ Disease. The prescription has been taking large doses of vitamin e for the misshapen penis and viagra for the ED. Electively, I also take ginseng, ginko biloba gotu kola, maca and Acetyl L-Carnitine. I also work out and swim five times a week, biking to and from those facilities. Obviously, I’m trying everything I can to stop all of this and have seen some result in the misshapenness but little more in the sexual function, mostly due to anxiety of losing it all. 

I guess my main questions are:

1) was my penis somehow damaged in the operation or did it somehow occur as something related in the recovery
2) what to do to recover?

In short, it has caused a lot of anxiety for me and a level of unpredictability with sex that I find even more anxiety producing, any suggestions on how to proceed with this are appreciated.

 apologies for the length of this....I’m a little freaked out

Hello, I am fairly new to the J poach game, my second surgery was May 20th. It has been a very slow recovery because of an extended stoma and irritated skin. Still, since then i have gotten the urge sexually to you know get off. My first attempt was kind of like my first time trying not sure what to expect two weeks after surgery. It was weird the discharge was yellowish and clear. I ask my doctor everything and said it was normal. My last few times, all was well, not as white as when I was healthy, more in the clear side, telling me I was still not 100 percent recovered down there. 

Still, I am going to see what happens after my stoma reversal on July 1st, it’s been a tough road, but thankfully the urge is still there I can get an election and get off, which is a good sign. I am assuming like everything all will heal up and get closer to normal with time. 

My understanding is that with the non-laparoscopic surgery it's 2% chance of permanent ED and 10% of temporary ED.  I was told to bank my sperm if I wanted to have kids.  I did not do so.  I ended up with no issues at all as far as ED right after surgery, although 20 years later did develop occasional ED because that is what happens to males when they age and hit their 40s, depending on various variables.

The risk may well be lower with laparoscopic, but my understanding from the conversations I had with my surgeon was that the colectomy aspect of surgery is what causes this risk, because the nerves are microscopic and it is extremely difficult to avoid cutting them.  Not sure what reduces that risk in laparoscopic because you can't remove the colon without cutting it, but there may be a more targeted approach in doing so with that procedure.  That being said I doubt it eliminates the risk.

Last edited by CTBarrister

I haven't lost it, but I definitely haven't been the same since. My surgeries were 11 years ago, and I was 24. Viagra is available as a generic now for about $2 a pill I believe, and it seems pretty easy to get these days with several online services. Exercise helps a lot, especially running for me, and leg and lower core workouts. I have found B vitamins to be very important, too.

Cialis is a little longer lasting than Viagra, and has less side effects. Exercise does help because erectile function is all keyed in to blood flow. At 35 you are still young and shouldn't need meds, but it is what it is. I never had any problems until I got into my 40s and that's when the aging process starts to take a toll on erectile functionality. Perhaps if you stay in shape and use ED meds you can manage it. But it does get tougher when you get older, regardless of anything else. My doctor analogized erectile function to a car engine- as it ages little things start to break down that prevent it from running smoothly and diet, health, weight, conditioning etc. all become more important.

Last edited by CTBarrister

I had my total colectomy about 16 years ago and my j-pouch surgery about 8 weeks after. When I attempted my first intercourse with my girlfriend (now wife) after the surgery I was not able to ejaculate, actually it was a little painful. This lasted for almost two months and I was getting gun shy of having any sex. My ejaculation finally returned to more or less normal (we now have two children) but it seems with less feeling, or pleasure (for want of a better word) when I orgasm.

For about 10 years after the surgery my sexual abilities were more or less normal (occasional erectile dysfunction  but infrequent) but since my mid fifties I have needed medicinal help and LOTS of stimulation by my wife to achieve an erection capable of penetration. We do still enjoy our sex lives though and appreciative of the times we are able to have it.

Some personal experience.

Male (obviously), 33, happily married, and I've lost all erectile function after the J-Pouch creation surgery (it was an open surgery due to previously formed adhesions). J-Pouches are still an extremely rare thing in Russia, but I've been able to find an experienced surgeon in Moscow. Still, it's never an exact science.

Around 3 months out I've had my first sexual dream, and now I'm slowly able to get a kinda half-boner. It's still nowhere near rock hard, but we're getting there.
I still have some sensation down there, and month after month it's getting a bit better. I am able to masturbate and get to an orgasm, but nothing comes out. Actually this part doesn't concern me, as I'm not planning on having kids anyway (was originally aiming for a vasectomy after takedown, but I wonder is it even necessary with retrograde ejaculation).

At this rate of improvement, I don't expect getting hard as in "penetration-ready hard" in at least another couple of months. I will consult with my surgeon after takedown (scheduled 3 weeks from now), maybe he will refer me to someone and fix me up with some meds, but I'm not undergoing another surgery to fix my erection. If it's permanent, so be it. It's not the end of the world.

I had my colon removal and taken down surgery about 18 years ago. I was 44 at the time with strong erections. For about a couple of months after the surgery I was able to achieve erections, but they were definitely not as strong as before, and when I orgasmed nothing came out. It was actually a little painful and I got a little shy of even trying to initiate sex.

It took a few more months, but I eventually started to ejaculate again (my wife and I have had two kids since). I never did fully regain the feeling or the firmness I once had, but lots of stimulation from my wife and Cialis make things work, at least good enough that we can be intimate.

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