This topic is about someone who is marking the two-year anniversary of having a stoma and is facing a tough decision regarding their troubled J-pouch. A stoma is an opening created surgically to allow waste to leave the body, and a J-pouch is a surgically created internal reservoir to hold waste. The person is dealing with complications and must decide on the next steps for their health and quality of life.

Here are some key points and advice shared by others:

- The stoma was created in July 2009 to address a life-threatening condition and has worked well for two years.
- A J-pouch was constructed in July 2010, but the first year was filled with severe complications, including pain and the need for narcotics and a rectal catheter.
- Despite initial tests showing a healthy pouch, further investigation revealed large abscesses behind it.
- Surgery in February 2011 aimed to improve drainage but led to further complications.
- An examination under anesthesia is scheduled for August to assess the pouch's condition and future prospects.
- The person is emotionally exhausted and considering three options:
1. Continue trying to make the pouch work, despite ongoing pain and treatment.
2. Opt for a permanent end-ileostomy, which their partner supports.
3. Stop now, fearing future regret if the pouch could have been successful.
- Concerns include lost academic time and the impact of another major decision on their life.

Additional questions and concerns include:

- What it feels like after the complete removal of the rectum and anus, including postoperative pain, phantom sensations, and appearance during intimacy.
- Surgical details about how the area is closed and what it looks like afterward.

Advice and insights from others include:

- Stay open-minded and give it time. Some suggest keeping all options open, as future advances might improve J-pouch outcomes. Focus on long-term goals, like medical school, while gathering all medical information.
- It's okay to choose a permanent ostomy if quality of life is suffering. A failed J-pouch survivor shared that a permanent ileostomy restored their health and normal life, emphasizing that quality of life is more important than the method of waste elimination.
- Personal relief after choosing a stoma. One member found life improved after making the irreversible decision, with no regrets.
- Experiences after rectum and anus removal include initial discomfort and phantom sensations, which fade over time. Long-term benefits include no anal pain, easier hygiene, and a normal appearance once healed.
- Surgical notes caution that surgeons may hesitate to remove the rectum and anus to keep future options open, but retaining these structures can lead to ongoing issues. Complete removal is more definitive but involves a harder recovery.
- Emotional support is available, with multiple replies affirming the person's courage and offering a space to discuss any concerns openly.