During the last decades several types of surgical techniques have been utilized in order to provide the patient with a continent colostomy using the colon as a reservoir. None of the methods have gained wide acceptance and continence is usually dependent upon successful irrigation. By constructing a cecal reservoir with an intussuscepted nipple valve, using the same principle as for the continent ileostomy, a colostomy with perfect continence for both gas and feces can be created. Although improving life quality significantly when successful, the method is hampered by a high rate of complications and malfunction. So far none of the methods introduced offer any great advantage to conventional sigmoidostomy with irrigation. There is, however, evidence that the functional results after coloanal anastomosis may be improved by constructing a pouch-anal anastomosis. The clinical significance of this technical modification is not yet fully evaluated.