This topic revolves around a 24-year-old woman who is facing recurrent infections from her rectal stump. Her doctor has suggested a proctectomy, but there are concerns about how this surgery might affect her fertility. She is looking for personal stories and experiences from others who have been through similar situations. Here are some insights and advice shared by others:

1. Negative experience and caution:
- A person with Crohn’s disease had their rectal stump removed and developed a serious infection within three days.
- This led to nine additional abdominal surgeries, resulting in adhesions and chronic pain. A small opening still produces mucus and occasional bleeding.
- They regret the surgery and emphasize understanding long-term healing issues and questioning the necessity of complete removal.

2. Positive surgical outcomes:
- One patient had their diseased rectum removed during a hernia repair. The recovery was smooth except for a slow-healing perineal scar, and they would choose to undergo the procedure again.
- A male patient who had a proctocolectomy five years ago reports significant improvements in life and sexual function, despite a challenging recovery.

3. Fertility after proctectomy:
- A woman who had an ileostomy at 15 and her rectal stump removed at 19 became pregnant easily at 20 and delivered two healthy babies vaginally.
- The births were difficult due to the desire to avoid a C-section through a heavily scarred abdomen, but they were successful with careful management.
- A post-surgical complication involved accidental cutting of bladder sensory nerves, leading to a loss of urge sensation but normal bladder emptying when timed.

4. Non-surgical or conservative measures:
- Use of topical natural antibiotics like suppositories with tea-tree oil, starting with a mild concentration.
- Healing enemas using slippery elm powder, marshmallow root powder, mixed with spring water or a specific brand of Aloe Vera known for removing irritants.
- Anti-inflammatory oil enemas using flax oil and olive oil in varying ratios.
- Emphasis on strict hygiene and using high-quality herbs and oils for enemas.

5. Possible alternative diagnosis:
- Diversion colitis, an inflammation caused by fecal diversion, can mimic infection and is confirmed by biopsy.
- It is less common with a loop ileostomy than an end ileostomy. Some surgeons prescribe short-chain fatty acid enemas, which can be costly.
- A loop configuration that allows minimal stool passage might alleviate symptoms.

6. General recommendations:
- Seek a second surgical opinion that focuses on preserving fertility and fully discloses long-term risks to the pelvic floor and nerves.
- Clarify why your doctor recommends stump removal, whether due to persistent infection, fistula, cancer risk, or diversion colitis.
- Weigh the benefits of surgery against potential adhesions, nerve damage, and fertility concerns, as making an individualized decision is crucial.