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Thw w-pouch is fine and not associated with significant long term problems, like the s-pouch. It is not done much in the U.S. because it is more time consuming and does not offer a better outcome in the long run. Also, if there is a narrow pelvis, it may be difficult, if not impossible. But, there are still a few surgeons who prefer it. I guess it depends on what they were taught and are accustomed to.

It used to be thought that it was superior to the j-pouch because it was a larger pouch, with more reservoir capacity. This is true in the short term, but over time, they wind up being very similar in function. I think the only complication I recall that occurs more often with the w-pouch is an overstretched pouch, leading to emptying difficulties, but that can happen with any pouch. Most comparative studies were quite small and did not take other factors into consideration. Bottom line, it should be a fine choice.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2780069/

jan Smiler
The W pouch was supposed to be the big improvement 20 years ago (can't believe it is that long) when I got mine due to the increased capacity. I had no significant problems until I got pregnant and needed surgery at 7 months pregnant due to adhesions and then again a month ago due to a kink in my small intestine. These were unrelated to the J/W debate. In the years after my surgery I returned to running and did a few half marathons and 1 marathon without having to stop for a bathroom break, but this may have also been the case with a J. Both J and W give you the usual sore bottom and going too often and leakage sometimes and certain foods a problem. I must admit that even though the W works well, I would be concerned if I was making a choice now about some comments on this forum about the W not emptying as well. The only time I have trouble emptying is if I eat too much of certain foods (like oranges or mangoes) that I know I should have in small portions. My fault! I usually empty very well. Your surgeon should be able to do either one, discuss it with your surgeon if s/he is the type to discuss it. Surgeons are not usually known for their people skills, mine sure isn't.

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