This topic revolves around the decision of whether to remove a non-functioning piece of colon, known as a rectal stump, after living with a colostomy for many years. The person in question has been managing a colostomy for 33 years and is considering the pros and cons of having this stump removed. Here are some insights and advice shared by others who have faced similar situations:

1. Reasons for choosing removal:
- Some people have a high risk of colorectal cancer, and removing the stump eliminates a potential cancer site.
- Issues like chronic bleeding, pain, or diseases such as ulcerative colitis in the stump can make removal necessary.
- For those experiencing constant urgency and mucus leakage that pads cannot manage, removal has ended these symptoms.
- Many have reported successful surgeries with minimal discharge afterward, healing fully within weeks when otherwise healthy and using an experienced colorectal surgeon.

2. Reasons for keeping the stump:
- Some have had severe infections or poor healing in the past, leading surgeons to warn of permanent open wounds if the stump is removed.
- Others find that recurring but manageable mucus output and pressure pain are preferable to undergoing another major operation.
- A long history of surgeries or mistrust due to past surgical errors can also influence the decision to keep the stump.
- Ongoing management strategies include using pads or pantyliners for leakage, suppositories or small enemas to clear mucus, and scheduled bathroom sessions to relieve pressure.

3. A middle-ground approach:
- Some opt for regular examinations, such as flexible sigmoidoscopy or colonoscopy, with biopsies to monitor for dysplasia or early cancer. This allows them to keep the stump while keeping an eye on potential risks.

4. Surgical considerations:
- It's important to be in good overall health before considering surgery.
- Choosing a surgeon with extensive experience in rectal stump excision is crucial.
- Outcomes can vary: some people heal quickly with no discharge, while others may experience long-term infections and nerve pain.
- Removing the stump means no future reconnection is possible, but it also eliminates cancer risk in that segment.