Hi there Feealicious,
I have had lots of experience with this exact situation.
UC gave me a surprise present when I was about 24/25 ( that was a very long year !!) , my plastic friend, now permanenr, Ileostomy. After about 3 years I was given the option of a J-Pouch. I jumped at the chance and said go for it !!
I had a great experience with the J-Pouch for about six years and then the Pouchitis began. First thing you need to know is that when Pouchitis begins then the Pouch cannot be saved !! In my case the UColitis emerged in my Rectal stump, almost none of that is left except for the Sphincter. The Sphincter was enough to reignite the Colitis. The docs use different names. You will hear it called Pouchitis, simply an inflammed pouch etc but the result is the same, the Pouch fails and it needs to be removed or at least deactivated. It was , as I say, really great for several years.
The toilet visits are 10 or 12 a day for several months after the Pouch is constructed. After about a year I was down to about four or five visits a day. This is when my life felt half way normal again. I could ride my bike for five or six hours at a time !!!! all over San Francisco and the GG Bridge. I had a gorgeous girlfriend for about a year, actually had three GFs during my Pouch Period. The third and final GF began calling me " the Tidy Bowl Man" when my visits began to rise in number. This was after about 7 years with the Pouch. In the end I could not depend on my Sphincter to function while we were being intimate. I never had an " accident " but sometimes I would have to jump up and run to the bathroom.....obviously causing much stress and ruining a delicate moment. This situation was a deal breaker as far as my GF was concerned.
Actually I did Not blame her, I couldn't ask her to put up with that so I believe now that I engineered a breakup to avoid any feelings of guilt she might have had. We finally split. I knew that my dance with "Normality" was over and it was back to pain and 10-20 visits a day...eventually . It frelt like shitting razor blades for years . I would not give up on the Pouch and get the Ileo back . The docs kept telling me that we could fix it. I used Vicoden to control the pain and the frequency. This worked for a long time but addiction will become a problem for many people using Vicoden or other Narcotics for an extended period of time.
My final word on the Pouch.....You might get between five and seven years of good times with it but it will eventually fail , in less than ten years typically. I am torn between regretting it and looking back at the beautiful memories that I created while I had the J-Pouch. Those years are like a different world in which I lived for a while, knowing that I would have to revert to the Bag eventually. I really don't think that I regret it because of those memories and the wonderful people I met during that time.
Having the reconnection without having the J-Pouch would be a bit of a disaster I think....just my personal opinion !! The Pouch mimics the Sigmoid Colon as a holding area for the "Stinky" stuff. Without the Pouch there is no " Holding area" at all so the Stinky just comes right out with No Control at all !!! from what I know about it . What caused the most pain for me was almost pure stomach acid that came out my butt. It burned the skin off my butt leaving the exterior raw and bloody at times, burned the skin right off !!
The inflammation and raw flesh eventually brought a risk of Fistula and Cancer and many other nasty things so I eventually asked for the Ileo back in about 2004. It was a very, very tough adjustment but eventuall I came to terms with it.
I am single and quite happy at this point . I may need my Sphincter removed at some point ( no real Rectum left ) and have my butt sewn up because I have some leakage and inflammation periodically and it may be getting worse.
Therefore I would Not recommend the reconnection without the Pouch. If you get the Pouch then prepare for failure after less than about ten years. The reconnection/ Pouch surgery involves several different surgical procedures and about a year of surgery and recovery before you start using the "Normal" exit properly.
Definitely ask about "Short Bowel Syndrome " if a J-Pouch is created since quite a bit of the small intestine is used in the creation of the Pouch.
I hope this was useful to you in your decision. As I say I look back fondly on the first few years with the Pouch but the final few years were a real challenge. The main thing to remember is that when the Pouch begins to fail, with Pouchitis, then the game is over and the Pouch must be reversed because it will never get better.
You have a tough decision so I hope I gave you some useful info.....just my story, I'm sure there are many other people who will advise you further.
Hugs , Eamon/ Magoo