W pouch?

It's my understanding that the reason the J is done more often than a W or an S is that it's structurally more sound and better functioning. Having said that I seem to remember a couple of members here having a W pouch. Hopefully they will see this and chime in. Good luck with your decision. 

Before having any surgery, you will want to be certain that you have tried more than one medication to attempt control of your UC and that your doctor has nothing more than surgery to offer.  My first surgery in 1981 was a straight connection with no pouch.  The number of BM’s per day did not decrease to an acceptable level, so he constructed an s pouch that has two loops instead of three with a w pouch.  Although my frequency decreased somewhat, I usually had a frequency of 8-12 (sometimes more) in a 24 hour period.  I lived with this frequency and a sore bottom for 30 years, which I felt strongly was better than having a bag.  I read somewhere that a w pouch can be a bit more difficult to empty completely than a j pouch, but that was not a problem with my s pouch. You may want to get a second opinion before having surgery.  Best of luck in whatever you decide to do.

Wow.... 30 years!  That's a long time.  I would be institutionalized long before 30.  Two was enough for me.  I got the ileo.  I just couldn't live like that.  And I was right.  I couldn't.  An ileo may be the end for some but it's a new beginning for me.  I am in a good place.... Finally. 

Richard 

I am surprised you can find a surgeon that still does a w-pouch. Early reports showed improved function, but in the long term they can become problematic. They can become overstretched and difficult to empty, and are more likely to need revision surgery or intubation to empty. There have been a few members here who had w-pouches. Over time, their pouches became dysfunctional and they required surgery. I suppose those who did not have issues did not register here.

Another issue is that they require twice as much small bowel to create, so if you develop pouch failure, there is twice as much loss.

While the w might have better function earlier, both j and w-pouches function about the same after adaptation. Because the j-pouch is by far the most technically simple procedure, it is the preferred choice.

http://www.ncbi.nlm.nih.gov/pubmed/19357929

Jan

Continuing with a procedure when things don’t turn out the way they were *supposed* to is a very personal and individualized decision.  I was able make adaptations to my lifestyle to accommodate bathroom use and BB pain.  During those 30 years, I held a full-time job, enjoyed alpine skiing in the Rockies and Sierras, entered equestrian competitions with my horse, traveled internationally and was active in the romance scene.  While others have found satisfaction and improved their quality of life with an ileostomy (and I am happy for them and the decision they made), this is not the choice I would make unless it was the only procedure that would save my life.

I agree.  It is a very personal decision.  I knew deep down it was not gonna work.  It was just getting worse.  

I applaud you for plugging along.  

I just couldn't do that for any longer and it was not a spur of the moment decision.  Nobody... Wants an appliance.  But as I move on with it I find its no big deal.  And that even surprises me!  The thoughts going through my head beforehand.  Oh man..... But now that it's done.  I am better off.  

Just a different way as is the pouch... Of doing it. 

Richard.