S-pouches fell out of favor because they are prone to structural/functional problems. Sometimes they are still done when there are intraoperative issues of a too short mesenteric reach.

W-pouches are OK fr the most part, but have an increased risk of an overstetched pouch hat is difficult to empty.

Bottom line though, while S and W pouches have a short term increased pouch capacity' in the long term they do not fare better. So, since the long term result is the same, it makes sense to do the simpler procedure.

Still, various surgeons have their preferences.

Jan

W-pouches are OK fr the most part, but have an increased risk of an overstetched pouch hat is difficult to empty.

Hello Jan, I have an 18 year old W pouch, which, in the last few years, has become difficult to empty. My doctor has limited knowledge/experience of this issue. I would be VERY interested if you could point me towards any further info on this topic.

Thanks, John

For the life of me, I could not find specific medical literature that pointed to that, but I know I read it somewhere, some time. Anyway, people with j-pouches periodically suffer from mechanical problems due to a too large pouch. Typically, it is related to anal stricture, leading to pouch outlet obstruction. This in turn leads to chronic pouch distension and incomplete emptying issues.

So, I guess it would make sense that a pouch that starts out larger might be more likely to develop this same issue. Sorry I wasn't able to find literature citings.

Jan

Thanks for your reply Jan. What you say makes a lot of sense to me as the issue came after i had an abscess which significantly constricted my emptying, decreased my frequency and hence stretched my pouch. i can live with it for now, while i lookout for pouch shrinking techniques!