I have had a J-pouch for 13 years w/no problems, until Jan. 2009. I had a skin tag removed and fisure tear repair in Jan. 2009. I started leaking badly, so I had another surgery July 2009 to repair what the surgeon called a divet around my spinchter muscle, only to get even worse (with leaking). Last week I went to Cleveland Clinic, and had several tests. The surgeon there said 1/3 of my spinchter muscle has been cut which is causing my leaking. The surgeon who originally did ALL my surgeries evendently cut too much! The doctors at Cleveland Clinic have got me on several meds. to try and heal "my wounds" b/c it has not been able to heal, b/c I go to the bathroom several times daily. If the meds do not work I will have to have a temporary ileo, 2nd surgery to repair my muscle, let it heal, and then a 3rd surgery to remove the ileo and to hook things back up for the j-pouch. If none of this works the specialist said I may have to get a K-pouch. I have to say I was very impressed w/the Cleveland Clinic. Has anyone ever had this problem or anything close? Please reply. Thanks!

I had a sphincter muscle repair when my pouch was about two or three years old. I had it done because I was leaking from day one. I then went to another surgeon who tried to "tighten it up" and said that I should have at least a 25% improvement. There was absolutely no difference and I have been told since that reparing the sphincter muscle for leakage rarely works. I believe that the original surgeon did something terribly wrong and he basically shrugged his shoulders and said he couldn't do anything more for me. Hopefully your doctors can help and I agree with you about the Cleveland Clinic. They are an awesome bunch.

I too had my sphincter muscles cut too much, which has lead me to be fecally incontinent since my takedown surgery in March of 2008. My original surgeon has never admitted he did anything wrong and I have spent the last year and a half trying to figure out what happened. I too was told that sphincter repair in cases like mine (no tone at all) rarely works. And after a lot of fighting with my insurance I'm having a K-pouch created this Thursday with THE K-pouch surgeon on the west coast, Dr. Dana Launer.

I'm very optomistic that this will give me my quality of life back. Something I have been severely lacking since my takedown.

i hope you find relief soon. I know how frustrating this all is and certainly must be for you since you lived for quite a while with a working sphincter.

Good luck. Let me know if you have any questions.

Allison
thechroniclesofcrap.blogspot.com

I am having trouble with leakage. It is hard to explain for me. During the day 'most' of the time I am ok, but then I will lean down or bend funny and I can not stop the stool from pouring out. At night I have accidents from about 1am -sometime into the late morning. I just had a scope and biopsy done that showed level 1 pouchitis. The pressure? test they do to look at your sphincter was all within normal limits. They are not sure why this is happening, the pouch looks great. We are going ahead with cipro for 14 days and hopefully this takes care of the incontience. If not I am scheduled for a 'collagen implant' around the sphincter Nov 20. I am not sure how I feel about this. So far it sounds like sphincter repair is a joke and just another surgery before you get some kind of ileo~be it perm ileo or K pouch.

Did any of you have leakage and get the repair with good results?

Sarah

could you explain what a collagen implant is.thanks

My understanding is that once there is damage to the sphincter or the nerves supplying it, it generally is fairly permanent (once you give it the 6-12 months to heal/repair itself). Cutting the sphincter I believe heals better than one that has been damaged by overstretching (as is done in transanal surgery).

I have not heard of collagen implants, but have heard of collagen injections, similar to what is done in cosmetic surgery for "plumping" the lips or improving facial wrinkles.

http://www.ncbi.nlm.nih.gov/pubmed/17048278

The only "implant" I have heard of is the artificial sphincter, which is not without its own problems. But, my dad had a urinary one that worked well (after the first one was defective and had to be replaced).

http://www.mayoclinic.com/heal...treatments-and-drugs

Jan

The collagen is from the small intestine of a pig? and then sewn into my spenticter muscle. I guess my body is supposed to adapt that tissue into my own???
This is the problem I am having with going with this surgery. I don't know hardly anything about the risks vs benefits, how they preform it, recovery... My office visit consited of the sphencter test, then office consult and then bam~this surgery was mentioned. It could very well be me not remembering I did have a pouchoscopy a few hours prior and all of those drugs were still floating around in me. But my husband was there and doesn't know anything of the details either.

I need to call back down to the C.C. to ask more questions. Until Nov 20 though I hope that these antibiotics work and I wont need the procedure anyway!

So Jan is it your thought then that "maybe" this is pouchitis and cipro will help? I am wondering if like you said once the sphincter is bad, its bad and I should just quite delaying the obvious and get a K or perm ileo? To much to think about, I just need this to work

Sarah

Lot of maybes there, so yeah, could be pouchitis. But, definitely get the full story on this collagen implant. Find out what the percentage of success is with that surgery, and what the definition of success is (an improvement in the leakage as opposed to completely fixing it).

It all depends on how much you want to keep your pouch.

Jan