Topic Explanation:
The discussion revolves around the decision to either keep or remove a rectal stump after an ostomy. The original poster is marking their 10-year anniversary with an ostomy and contemplating whether to undergo surgery to remove the rectal stump, which has atrophied and narrowed. They are seeking advice from others who have had similar experiences, including those who have undergone j-pouch surgery or complete removal, and are curious about surgeries that leave the anus intact due to concerns about pain and recovery time.

Extracted Advice and Helpful Insights:
1. Surgical Options and Experiences:
- Some individuals have undergone ileorectal anastomosis, total colectomy, or had their rectal stump removed while keeping the anus intact. These surgeries vary in invasiveness and recovery times.
- Laparoscopic surgery is mentioned as a less invasive option, with manageable pain that typically subsides within a few weeks.
- J-pouch surgeries have mixed reviews; some have success initially but face complications like frequent bowel obstructions and bloating years later, leading to the removal of the J-pouch and a return to an ileostomy.

2. Recovery and Long-Term Outcomes:
- Recovery experiences vary widely; some report significant pain and complications such as bowel obstructions and sepsis post-surgery, while others have minimal issues.
- Long-term, many express satisfaction with their decision to remove the rectal stump, citing reduced pain and improved quality of life.
- Concerns about potential nerve damage affecting bladder and sexual function post-surgery are noted, though specific outcomes can vary.

3. Personal Decisions and Considerations:
- Decisions are often influenced by the severity of symptoms like pain and pressure from the rectal stump, as well as the potential risks of cancer or other complications if the stump is left in place.
- Some individuals opted for stump removal after experiencing severe symptoms or receiving medical advice about increased cancer risks.
- Emotional and psychological factors play a role, with some individuals expressing relief and a sense of calm after making a decision aligned with their personal health circumstances and lifestyle needs.

4. Monitoring and Maintenance:
- For those who retain their rectal stump, regular monitoring through scopes is suggested to check for any changes or complications.
- Discussions with healthcare providers about the risks and benefits of removal versus retention of the rectal stump are crucial, especially when considering