119 patients (ulcerative colitis 98, polyposis 20, Hirschsprung's disease 1) were treated between 1976 and 1985. There were 1 operative death (0.8 per cent) and 7 failures (5.9 per cent). Three- (68), two- (13) and four-loop (37) reservoirs were constructed. The ileoanal anastomotic complication rate was 25, 15 and 8 per cent respectively. Mean frequency of defaecation was 4.2 +/- 1.3. Continence was normal in 77 per cent; 4 per cent had a significant faecal leakage. Modification in reservoir design has completely avoided the need to catheterize. Quality of life after the operation was preferred to an ileostomy by 96 per cent of patients with an intact reservoir.