I guess I was already an "old man" when I got my FAP diagnosis and J-Pouch/IPAA three years ago, at age 51.  Given the options, I am very grateful for having had this surgery.  Yes, my life has changed in some ways - and I am, unfortunately, a male whose sexual function was, indeed, significantly compromised by the surgery - but I cannot imagine the surgical scar being a big deal regarding self-image, and in the big scheme of things, I quite likely would have already died of colorectal cancer gone undetected and run amuck had things occured in a different way; versus now being able to watch my kids grow, continue a productive career, and in general enjoy and see how things will turn out for my family and those I love and care about.  So the trade-offs have been well worth it to me; glad to have the opportunity to be a "pouch person."