After I got my J-pouch my daughter convinced me that we should study Japanese Ju-Jitsu  together, and to my surprise we worked hard enough and spent long enough at it that we both became instructors. My pouch was the reason I *could* do that, rather than a reason I couldn’t. But Japanese Ju-Jitsu mainly trains cooperatively rather than competitively, and I only took a small number of direct strikes, so my experience was different from what you are planning. The pouch is really (mostly) in the pelvis rather than the abdomen, so I’d guess that other organs (e.g. your brain) and your knees are at greater risk than your pouch.

FWIW when I’ve worked with MMA-trained folks they seem compelled to take the fight to the ground. This is a fine strategy for a cage match, but a terrible self-defense strategy, since you can rarely be certain about whether there’s a second attacker.

Like Scott said, your pouch is mostly in your pelvis, so I think you are  relatively safe in that regard.

However, I  had a two step process, and I have taken some accidental hits to the former stoma/takedown site.  That spot is still sore two years later. My fear is that some scar tissue will break off or decide to relocate itself.

maybe some rib protection device that wraps around your abdomen should be considered if your paranoid like I am about something going amiss during this activity.

New577 makes an excellent point. I had no stoma, but like anyone after abdominal surgery I have adhesions, and those don’t slide around quite like an untouched gut. A sudden blow to the wrong spot can cause an adhesion to pull hard on something soft, and that can cause trouble.

thanks for the input, guys! its much appreciated!