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26 yrs old and a rectocele repair yesterday

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Hi, its a crazy feeling to be posting on here as this forum has been a source of inspiration and info for me for over 2 years as i tried to make a the most informed decision possible on what type of surgery to do if any.

Im a mom of 2. Having my first baby at age 20 and noticing a urethral prolapse (though i didnt know what it was) during pregnancy.. followed by a mild rectocele that required splinting for BM for the first year postpartum. I had a episiotomy that i believe failed, as my vaginal haitus (opening) seemed to get longer with time as if going down the stitched path.

Then i sort of took a haitus from looking at my lady bits for a few years as it was just causing me grief not knowing what was wrong with me, that and i had a toddler to chase around.

At 24 i became pregnant with my second baby, who ended up being in the 100th percentile for head circumference and 98%tile for weight (9lbs 2oz). This did a number on me. Suddenly i was experiencing extreme vaginal flatulence, needing to digitally compress from inside my vagina to have BMs and no grip what so ever during sex.

I did some research and came to the conclusion i had a cystocele and rectocele and saught out a surgeon in my area. He confirmed that i had a grade one cystocele, grade 3 urethracele and grade 2 rectocele. He was a one trick pony though and only did surgery involving removing the uterus and suspending everything with mesh. I had no interest in mesh or uterus removal but he said i was too young for insurance to ever allow this surgery anyway.

That stigma followed as every medical professional i spoke with made me feel as if i was the youngest woman alive to have these problems. I cant tell you how horrible that feels.

I saw a pelvic floor physical therapist for a year. I learned a lot from her and things improved a lot. I was always thin, but gained 60 lbs during pregnancy and she helped me to lose the weight but gain back lean muscle. She helped me to resolve my constipation (normal for me was a BM every 2 weeks) and to squat while using the bathroom which completely ended my need to manually express.

But one thing she was unable to do was whip my "loosey goosey" pelvic floor muscles back into shape. Despite all our work we couldnt get them back to midline. The electrical muscle stimuation didnt work because the wand was too small and couldnt press against my far stretched muscles.

So this led to me to seeking out surgery from a gyno at the obgyn office i saw a midwife at for my 2nd baby. I wasnt really able to be honest about my reasons for seeking surgery as he quickly shut me down when i started to speak about sex in reference to my muscle laxness. Its such a shame that society treats women as objects of lust that are not to derive any pleasure from such a natural act!

I had surgery yesterday and was released 6 hours later. I wasnt feeling up to it at all because the anesthesia made me really sick but my little one still breastfeeds and was having a meltdown with me being gone for the first time ever.

The surgery itself went well, except afterwards i asked my surgeon if my muscles were moved back to a normal positioning and he said he "didnt touch my muscles". I was told several times the fascia rectovaginal fascia would be sitched, excess vaginal skin would be removed and the perinium would be "built up". Yet my PT was always trying to make me do pelvoc floor exercised so the surgeon would be "stitching together two pieces of paper". I told my surgeon that he only said it wouldnt be a problem. Sigh. Only time will tell how things go, i guess.

Sorry for such a long post.. i have spend the past 2 years reading these forums and using it, along with info from medical journals, to come to the decision to go ahead with surgery. So i want to thank all of you. I am happy i finally went along with it

I dont have any friends or family to talk to about this so i hope that some of you can continue to be a guide for me.

Have a great weekend!

JEN

2 likes, 30 replies

30 Replies

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  • kp1407
    kp1407 Guest

    Edited

    I can really relate and sympathise with you. I had my first child at 22, second at 28, and shortly after noticed problems which was later confirmed to be rectocele. 

    Every doctor and consultant I saw would proceed to tell me how young I was for surgery and how I should wait a few years, and finish my family. I have finished having children and made it perfectly clear to them there would be no more. 

    Anyway I was referred to my local women’s hospital who have been amazing and my surgeon is just wonderful. I’ve met him so many times, he’s personally checked me over before and after, and he’s been very thorough and understanding. I’m currently 4 weeks post op, feeling much better now although not 100%. 

    I hope you do well in your recovery and can live a much better life afterwards. 

    People don’t realise how much it can affect you having a problem like this. It’s very isolating because it’s not something you can really talk openly about amongst people is it! 

    • Guest
      Guest kp1407

      Posted

      I'm happy to hear that things are going well for you at 4 weeks post op! I look forward to being where you are. I've heard that the chances of occurrence are higher because we are younger and the results need to last longer, but I like to think that because we are young if we take the time to properly heal and make sure to stay regular the results we last a very long time!

      Once I was able to to get my BM on a regular schedule I really felt that my rectocele was non existant. My thoughts on surgery was that with age the prolapses would only get worse and the looseness I was experiencing could only be taken care of with rectocele surgery. I declined to get a urethra sling, as I felt strongly against using mesh knowing how my body reacts to unnatural things, and because i feared it wouldnt do anything for the sagging wall and would just create a kink that could cause more problems. I really only felt it to be a cosmetic problem. A tiny pee when i laugh is no big deal. My true fear is though that the sagging urethra wall will push down against my lower wall and cause it to give way as well. This is something that I felt I watch happen to my episitomy, but my surgeon seemed to think that was impossible and wouldnt be able to undo his work. Thankfully.

      how were your first weeks post op? Any advice? 

    • kp1407
      kp1407 Guest

      Posted

      I had a rough first few weeks to be honest. I had to go back to hospital on day 4 due to heavy fresh bleeding. I was internally examined and a clot had built up between the repair and the layer of stitches over the top, which then opened up the top stitches and the clot and all the other blood just let loose. It was pretty grim and it really set me back. I had to stay in hospital on IV antibtiocs as it caused an infection and I was quite poorly. My surgeon didn’t want to go back in though as he said it would heal itself. It’s not the actual repair just the layer they fold over the top and stitch. I had a check up 10 days ago and he said it’s healing well, and I’ve got another appointment in 2 weeks for another check. 

      I’ve rested so much. It’s boring and I feel like such a burden as I have two young kids and I need constant help with them. I was told I wouldn’t be able to lift anything heavy ever again. That it was a lifetime limitation. 

      I get sore and extremely tired if I do too much. Which I find really frustrating as I just want to drive and get out. But hubby won’t let me drive yet. 

      It’s a long recovery process, like you I researched a lot beforehand so I was under no illusions. But it’s still been worse than I ever imagined. However I do think it will be worth it in the long run, fingers crossed. 

    • Guest
      Guest kp1407

      Posted

      You are describing my worst nightmare... I can only imagine how hard it must have been to have to leave your little ones at home and return to the hosital. So happy to hear that its behind you and youre healing well and back on track.

      Something you said caught my eye. The part about

      the infection being in the skin that was folded over. I know theres a few different techniques out there surgeons use... are you saying your surgeon peeled back skin to stitch the rectovaginal fascia back together and then folded the right and left peeled skin overlapping eachother? Thickening the skin as extra support? My surgeon said he was going to peel back and then cut it out and suture thr skin closed tighter. The way you described sounds more supportive but perhaps riskier infection-wise?

      It never occured to me that the weight limitations could be because of pain, not just a possibility of ruining the scar tissue. Somethings dont really click til youve commited.

      If you dont mind me asking, did the surgeon suture any of your muscles together to make them tighter or stronger? I fear that my now more narrow vaginal canal is going to go back to what it once was without muscular support. Is muscle reapproximation generally something thats always done in conjunction with posterior repair?

    • kp1407
      kp1407 Guest

      Edited

      I think that’s pretty much what was done yes. When I found out I quite liked that there was a layer over the repair. I feel like it will be more secure and stronger. I’m not sure what other methods are used to be honest. It’s  the one thing I didn’t really research and my surgeon said he would decide when he was in theatre the best option for me, as I was possibly going to have anterior repair too but he felt that wasn’t needed. 

      I’m unsure about the muscles. That wasn’t really an issue for me. The main problem I had was BMs and having to manually expel. The actual walls and structure of my vagina weren’t a major issue, I mean it was obviously not what it was before kids! But it wasn’t causing me sexual problems or anything. It was more the bulge at the vaginal opening that caused me problems. However now I honestly dread to think how anything is gonna get in there again as everything just seems so tight. I’m sure a lot of it is still swelling though perhaps. 

  • Gillian22766
    Gillian22766 Guest

    Posted

    Hi love this was my journey 

    April 2015 polops removed paid for2.500

    July 2015 hysterectomy paid for 6.500

    I new there was something wrong after the hysterectomy because I could feel a marsion in my vagina the surgeon kept putting me off finally I took a picture went back in jan 2016 and wouldn’t leave until she told me what the problem was and it was a prolapsed back and front she agreed to do my operations on the NHS eight weeks after I had 

    A&P surgery and nothing could have preperd me for that it is a very long process of healing but I did it to the book I only did small soft amounts pelvic floor at six week after and there were times were I couldn’t feel anything but I have got there, I took a bit to get the sex right, now 18 month on, the changes for me are life long I will not carry anything for long periods or over 5 pound as the repair hurts.

    I if I can tel you only one bit of advice listen to your body and when you feel the pressure below rest and rest again

    Take care and I hope you heal well 🌸

    Gill

    Matron hi if you are still on 

    • Guest
      Guest Gillian22766

      Posted

      So you feel that the rectocele repair is harder than the hystorectomy? Wow. I was told I would be up and walking around, could easily lift my 18 month old daughter and back to normal within a few weeks... I knew from my extensive reading of forums that it wouldnt be that easy but I figured if that were true of anyone it would be me, but certainly not! I did go into this knowing I was going to double my recommended pelvic rest to 12 weeks as I really understand now the importance of creating that scar tissue! 

      I cant help but fear Ive already messed things up though (i have paranoid anxiety like that) and the fact I got it done while on my period is making it hard to tell whats bleeding from my surgery and whats menstrual.

      am i righht that you said you felt rectocele recovery was harder than

  • paddiwhack
    paddiwhack Guest

    Posted

    Hi Jen

    Wow it does sound like you have had a lot to contend with and with a toddler and baby to care for. I do hope you have lots of support around you at home. If possible don’t lift your baby, or anything. No pushing or pulling and you need to rest rest rest. I am glad you are pleased you have had the surgery and I hope that she. You are healed the intimacy between you are your partner will be improved.

    I don’t know why it is so taboo but people can be very prudish and just won’t talk about these things. I think if we talked more it would normalise a large problem that many women, of all ages suffer from.  Men need to be aware too! I am so lucky that my husband wants to understand and is therefore very protective of my adequate recovery.

    Wishing you the very best

    • Guest
      Guest paddiwhack

      Posted

      How long would you say is best to stick to thid do nothing but rest rest rest diet? Do you know how long it takes to make sufficient scar tissue down there?
    • paddiwhack
      paddiwhack Guest

      Posted

      Hi Jenex sorry for my delay. I was told the first month is crucial but even after that one has to be very careful. No bending no lifting and limited time on your feet.

      From what I have learned on this forum particularly is that we all heal at different rates and all have procedures carried out by different surgeons.

      What I do know is that it takes a year for scar tissue to fully heal and regain full strength so even when a wound looks healed there’s a lot longer required to be fully healed. In my opinion it’s a big op a long recovery, but why go through all this and ruin it by trying g to run before we can walk. 

      Generally I believe you can feel how well you are and need to listen to your body. Get as much advice as you can. If in doubt, don’t do it.  Good luck 

    • Guest
      Guest paddiwhack

      Posted

      Wow a year for fully healed scar tissue. If weight bearing and bowel movements and bending can cause damage why the go ahead on sex after 6 weeks? Do they assume husbands just wouldnt let women get the surgery if not... I knew i wanted to double the traditional 6 weeks, thinking scar tissue may take 10 weeks to create... certainly something to think about...
    • paddiwhack
      paddiwhack Guest

      Posted

      Initial healing of the wounds is six weeks which I think is why this is the margin. At 12 weeks more healing of fibrous tissue.

      I can’t see me being ready and relaxed enough in four weeks to attempt intercourse. Mind you I am menopausal too and need to commence oestrogen cream too and that should then make me more comfortable. We each have to decide when we’re comfortable with it and use plenty of lubrication too

  • pamela1937
    pamela1937 Guest

    Posted

    I am so sorry to read this Jen, what a bad time you are having. I will leave the experts to deal with this but good luck for the future and I'm sure you will get lots of help from this lovely site, I know I have.

  • Redhead1960
    Redhead1960 Guest

    Posted

    Hi Jenex, my heart goes out to you and I wish you a full recovery. There is so much misinformation and prejudice  out there about prolapse even within the medical profession. Thank goodness you have finally had surgery as this is probably your best chance of recovery.  When I finally found an appropriately qualified and experienced urogynaecologist some of the misinformation from other medical practitioners I had seen was finally dispelled. I had Rectocele, Cystocele and uterus prolapse, grade 2 and had my operation 4 and a bit weeks ago. The things I learned was that although pelvic floor exercise are important and will always be required and  they can improve the muscles, sensation etc., they cannot magically repair the stretched skin that a persistent prolapse has caused. Factors such as weight gain, lifting heavy weights, constipation, and later the menopause etc can all work against a repairing a prolapse. Initially the advice I was given can be summarised as get on with it, it's not life threatening, it is life changing. No advice or referral to a specialist was offered, in fact I wasn't even examined to confirm that there was a prolapse or the degree of prolapse. When I asked if I was suitable for a ring pessary to relieve the symptoms, I was told by a doctor that as I was sexually active, this was not possible...... Ignoring the fact that I had told her I was unable to have sex, exercise etc because of the prolapse. In fact she was wrong. There are rings which can be used to support prolapse and which do facilitate intercourse. My urogynaecologist fitted me with one and explained that the first doctor was sadly misinformed. I still opted to have the surgery as you have done after much soul searching and weighing up the risks as this is the best chance of being  able to have a sex life and correct the bowel and bladder issues that have dominated my life for the last year. Even all hope that the surgery will be successful in the long term and our only surgery.  I did explore with my consultant the complications and what the risk factors were to further prolapse and intervention. I know to do my utmost to avoid constipation, take great care with post op recovery, keep the vaginal walls healthy with local oestrogen, safe exercise protecting the pelvic floor, maintain good weight etc but if ultimately  in my lifetime, I prolapse again, use of a ring or further surgery is still an option so I hope this is the same for  you. I am hopeful with the current surgery I will feel confident to try and enjoy intercourse again in the coming months, but already I know that I can have an orgasm. I was told by one female gynaecologist that g spot orgasms would likely be a thing of the past, but the urogynaecologist did say that although the g spot might be in a different place (!) in theory as he wasn't cutting into muscles, it should still work, but frankly he had never been asked the question or been told of women's experience of this specifically post surgery so had no actual data to rely on!

    Anyway, probably too much info, but hopefully gives you some hope on what seems to be a taboo subject......... Women wanting to have and enjoy a sex life! good luck with your recovery and look after yourself.

    • Guest
      Guest Redhead1960

      Posted

      I was told the same things about pessaries and although that wouldnt have been a game changer for me, some research showed it could reverse the prolapse to a small degree, so i figured it couldbt hurt. I have asked 2 different doctors now about prescribing me estrace to bring some life back to the tissue down there (PT told me the very light pink almost white coloring means lack of blood flow and estrogen therapy would help me a lot) that seems to have gotten very thin and smooth as the prolapses progressed... but neither seemed to think it was appropreate "wouldnt make a difference". Thats when i learned that there are key things you have to tell a doctor to get what you want. You want surgery? You have to say you cant have bowel movements (most women i think who have some degree of prolapse are so embarressed by this they never say anything and then are never diagnosed). You want estrogen therapy? You have to say your vagina is painfully dry.

      I hope that you have great long lasting results with your surgery and that it allows you to go on to have a wonderful sex life as well. Its good to know at the end of the day at least you can make your own fireworks

    • Redhead1960
      Redhead1960 Guest

      Posted

      Thanks Jenex for your good wishes. You are so right in how we have to tailor the information to the medical profession get the appropriate treatment and support we need. I was just so relieved in the end to find a GP eventually who recognised the impact the prolapse was having on my quality of life and got me referred to a urogynaecologist who laid out all of the options for me. It was a long and dreadful journey to that point and I wish I could have found my voice earlier to get the right help sooner. 

      In terms of creating appropriate scar tissue, I think the initial healing takes at least 6 weeks but the thickening of the scar tissue takes 12 weeks. I also understand that the first layer of stitches take about 3 to 6 weeks to dissolve, and the deeper layer stitches about 12 weeks. The stitches for sacropinious fixation are permanent and do not dissolve. But others may have more info on this. I am 4 and a half weeks post op and not noticed any stitches dissolving and bled for over 2 weeks and again for a night at 4 weeks after I had walked too much one day. A reminder for me to take it easy even if I feel I want to do more. 

    • Guest
      Guest Redhead1960

      Posted

      Ive not heard of that fixation method? What is its function? Is it simular to the abdominal approach to fixing the urethra by suspending them with permanent sutures?
    • Guest
      Guest

      Posted

      Ah i did a little research and found out.. im assuming you had a hysterectomy then went on to have A&P repairs after?

      I have a very apparent urethracele but the urologist here says he would only do a bladder sling which wouldnt actually correct the appearance of it drooping into the vaginal canal so i skipped that as i dont have much trouble with incontinence. My cystocele is grade 1.. i cant see it of course but am able to feel it if i go poking around inside. My surgeon said he wouldnt touch it as a grade 1 cystocele is a natural place for someone whos had 2 kids and non symptomatic..

      . i just really hope he knows what hes talking about and hope that not repairing the urethracele and cystocele doesnt interfear with the rectocele correction or that the surgery doesnt cause the cystocele to get worse some how as others often describe surgery to do... although from what ive read that usually has more to do with hysterectomies...

      Sorry if TMI i suppose being bedridden and finally able to talk about this has me exploding all over the internet haha hope youre havin a good night : )

    • Redhead1960
      Redhead1960 Guest

      Posted

      Hi Jenex, the sacropinous fixation was to lift my womb/uterus which was discovered to have also prolapsed during the surgery. They stitch the top of the vagina vault to the sacropinous ligament and this lifts the uterus up without shortening or reducing the width of the vagina. It has a great success rate of 95% compared to 70% of the bladder and bowel prolapse surgeries so actually I was quite pleased to have it done and it should by lifting everything up help with supporting the other procedures to correct the bladder and bowel prolapses. I am in the UK so procedures and treatments may be different elsewhere. Good luck with your recovery and hope you get all the help and support you need.
    • Imnotadoctor
      Imnotadoctor Redhead1960

      Posted

      Sorry to jump in on your thread but I noticed what you said about the fixation. I had a double bilateral sacrospinous fixation 16 days ago & was told the stitches are not permanent. They dissolve at 12 -16 weeks and are replaced by scare tissue. Maybe different stitches can be used? 

      I've learned more on this site than anywhere else!

    • Redhead1960
      Redhead1960 Imnotadoctor

      Posted

      Hi, I understood from my consultation that the stitches were permanent, I think pig gut was used for me which sounds gross. There are some resources available on the South Tees information section of this forum and this says either permanent or dissolvable stitches can be used, so I guess it depends on the surgeons preference and also the patients condition. Apparently one of the complications can be that you end up with pain in the butt cheeks if the area over heals and scar tissue gets too tight in which case he said my stitches would be either loosened off or removed and dissolvable ones put in. But so far so good, I haven't had any butt cheek pain as he described but I am only coming up to 5 weeks post op. Having my post op check at 7 weeks but hoping to be told that all is healing well assuming he has a look at it all! 

    • Imnotadoctor
      Imnotadoctor Redhead1960

      Posted

      I must admit I did feel as though I'd been kicked in the bottom by a horse on days 2 & 3! My consultant told me it's all to do with a nerve (which they can't see or feel) at the time of stitching. If they catch this nerve it can hurt for a few days or possibly weeks but should pass.

      Hope you continue to heal well. 

    • Redhead1960
      Redhead1960 Imnotadoctor

      Posted

      Yes, he mentioned that they might catch a nerve, but it can settle down again of its own accord. Good luck too with your healing. 
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