Pelvic pain after urethra lift and rectocele repair

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i am 3.5 weeks post surgery (rectocele repair, mesh lifting urethra for incontinence issues and I hav external stitches on perenium to bring muscles back together). 

I am healing a lot slower than expected and I wondered if any one else still had pelvic pain at the 3-4 week mark?  (feels like a bruise and is worse when standing) also get pain in my but cheek if a walk around too much. 

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  • Posted

    Hi Lizziep,

    Not had mesh lift, but had A&P repairs! Don't know how the mesh lift goes but the rectocele repair can take up to 16 weeks to start feeling normal, and deeper tissues even longer.

    They don't warn us that recovery actually takes much longer, 3/4 weeks is very early days as yet.

    I had ongoing problems with scar tissue and a horrible achy pain in lower pelvic floor at the back but was told it was back pain and nothing to do with repair.

    I disagreed as I've never had back problems ever, anyway I think it is to do with all the nerves and ligaments that criss cross across the pelvic floor and when I overdo things (on my feet more than a couple of hours) it's agony. The area around vag... entrance gers very nippy too, so GP prescribed Estriol topical cream and if has helped to aleviate the nip from scar tissue as it thickens up the tissues and help the repair also.

    Never got appointment for my referal for back pain but don't see the need as I managed to eventually negotiate more time sitting at checkout at work and have managed to find ways to avoid mist if the heavier weight bearing at the till.

    Anyway 8n my opinion the dragging pain at back of bum ( if similar to prolapse pain ) is your body telling you not to overdo things. It's a long slow recovery and takes time to build up activity. Please be very careful as the stitches don't start to loosen off until wound is healing and that starts around 5 weeks so can get uncomfortable as stitches loosen and internal walls resettle. Take progress slowly at least until around 3/4 months.

    I was told my repair will last as long as I don't put any down pressure on my pelvic floor.

    Take care,

    Phyl x

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    • Posted

      Hi Phyl, hope you are doing ok. You are right, it takes a lot longer than we are told when we have this surgery, 16 months since mine and still painful to sit for long, very thin tissue on perineum, though that could be to do with age and post menopause so not enough oestrogen. I have been just prescribed the estriol cream, have been taking oestrogen rubbed on arms, but makes me too swollen, not good. Did it take long for the topical one to start to work?

      Is Matron still around? Haven't seen her on here for ages.

       

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    • Posted

      Hi Laura,

      I'm doing all right but still restricted to some extent, but think that's just the way it's going to be.

      Managing my 2 shifts and swimming once a week, but still can't be on my feet for longer than an couple of hours without having consequences.

      My front repair is holding up and very strong thus time but I think the swimming is helping that, but back repair gets saggy when I overdo things so time will tell with that.

      The Estriol is a lifesaver, I couldn't give functioned without it; if helped within a short time but I think I didn't get the full benefit of that until about 6/7 months on it and if I stop it for too long skin tissue/internal walls thin down again after a while so continuing to use it.

      Don't think Matron is on the forum at the moment and hasn't been for some time although still involved behind the scenes; last time I heard from her she was preparing new material based on the research they were doing for the helpful resource section so looking forward to that and hoping it will be useful for advising employers/occupational health workers as well as us patients.

      I believe she was intending to retire from this work, I had suggested she should still be on the site at least as former patient as she has undergone prolapse surgery herself and always had the best advice to keep us all right. Many of us miss her.

      I'm sure you will benefit from the Estriol cream,

      Take care,

      Phyl x

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    • Posted

      I will stick with the estriol, I was on and off the gel, but I am sore and have a lot of pain, think the swelling made it worse. I have seen a colo rectal surgeon, and have a fissure, so could be that causing the pain, but seems so far forward. Rectocele repair seemed to set it all off, then didn't know what was causing what. Think it's all connected. I really should get back to swimming, my weight has gone up and I'm really unfit, but worried about stretching tissue that is so thin already.

      Yes Matron was a big help, and as you said having had a repair herself understood it from both sides.

      Glad you are coping and repair holding up.x.

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    • Posted

      I'm the same with regard to my weight, I have such a sweet tooth, but trying to watch what I'm eating as I can't run it off in the gym any longer. I've cut my portion sizes and at least try to get swimming once a week or at least a long walk.

      Swimming can overstretch things too so have to be careful. Hubby always says to eat less and move more but not easy to up the move more due to repair restrictions.

      Feel like always fighting to stay fit all the time.

      X

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  • Posted

    Hi Lizzie,

    I haven't had my rectocele repaired yet but I have had an anterior repair so I have some idea how you are feeling.

    It takes a long time to recover, 3 weeks is still very early days I'm afraid. In fact at 5 weeks everyone seems to go through a low period, I think it's to do with the stitches. My doctor has told me it will be 16 weeks for the deep stitches.

    Make sure you go for your post-op check up & mention any concerns to your doctor. Good luck.

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  • Posted

    Stick with it Lizzie and rest as much as you can. It does get better, but as the others have said, very early days for you. Try not to get too down, it can be a very emotional time, and the pain seems to last for ages, we're talking months, not weeks. If it's been successful it will be worth it in the long run.x.

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  • Posted

    I had a rectocele repair with a biological mesh and it took me much longer that that to feel normal.  I just checked my Fitbit.  Started tracking 18 days post op -  1150 steps.  Week 3 was about 2.5k average.  Week 4 about 4.5.k.  Took me till about 11 or 12 weeks to get to 8.5k average.  6 months to get above 10 k, but I think the last one was the limitations of my back not the surgery smile. As you can tell I wasn't doing very much early on and it took me about 14-16 weeks until I stopped having vaginal pain when lifting a gallon of milk.

    1 year later, the urogyn at the followup said the repair looks great.

    i read Sue Croft's book preop "Pelvic Floor Recovery: Physiotherapy for Gynaecological Repair Surgery" and it really helped.  It explains thing about from the anatomy to how to get out of bed with tubes in you to the recovery period and gentle exercises (and when you can do them!).  Her timelines were much more cautious than my doctors so I followed hers.  Obviously I feel your doctor said to wait longer then you should.  It made me feel much more normal during recovery instead of like someone who was struggling when it was sooo easy for everyone else.   

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    • Posted

      Hi DorryC,

      Hope you are doing well. I think that's the problem with specific advice that we all have different degrees of prolapse and therefore different extent of surgery and follows too that recovery can be quicker or slower too.

      I think yok that younger women who are pre-menopause can recover better and quicker while those of us post-menopause have weaker ligaments and thining walls which slow down the healing process.

      So difficult to get the balance right between staying fit and managing work but not overdoing things and causing down pressure that could lead to failure of repair.

      Take care,

      Phyl x

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    • Posted

      Yup, I agree that everyone is different and pushing to do things you aren't ready for causes problems.  I took things slowly, gradually increasing what I was doing and spending most of my time laying down, not sitting.  Slow walking was all I did early on and my walks very short (and frequent!).  My doctor seemed to think I was back to normal at 6 weeks which was laughable.

      I was 41 when I had the surgery, so premenopausal.  I think the defecography said my rectocele was 5.3 cm, which is quite big.  I am a stay at home mom and my husband took time off for 6 weeks.  After that my 13 year old daughter was a lot of help.  My youngest was 3 so a lot of adjustments had to be made so he felt loved and taken care of without me actually picking him up at all.

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    • Posted

      that said, I found Sue Croft's book much more realistic than what my doctor told me, in terms of what to expect.  It has a lot of information and I found it very helpful and I strongly recommend it.  Amazon has it as an ebook in the us and  U.K.  I think it was 10 USD.

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    • Posted

      Wish I had had that kind of info after my first repair, maybe it would have been successful and lasted much longer.

      They reckon that every time you have repeat repairs done pelvic floor gets weaker. So good to get it right first time!

      X

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    • Posted

      Yes, I'm so thankful I found it.  The information from the book really helped me take care of myself and plan on needing lots of help for a good long time.

      One thing she says in the book is somthing like "make your first repair your best repair and your last repair".  Even if the doctor does a great job with the repair, it doesn't do much good unless you take care of yourself and let your body heal properly.  It's frustrating that doctors don't give enough information (or perhaps just don't get) how long recovery can take.  I think matron was working on getting better information to patients in the NHS which is great.

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    • Posted

      Yes, last time I heard from Matron she said new info will be ready soon!

      I wonder if any researchers have actually followed patients through from diagnosis, surgery to full recovery. It would be interesting to hear just what percentage of repairs really are successful.

      Anyone I've spoken to is either suffering and too scared to go for surgery or has had repair and are not working as retired so able to take it easy.

      I think many of the younger women tend to regularly attend gym and repairs don't seem to last. Different lifestyles from our mothers.

      Anyway think the NHS need to educate us better after childbirth and be blatant with regard to prolapse. Maybe we would take our health more serious.

      X

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    • Posted

      Phyl, I'm 37 so I expected I might heal faster. 

      I got out today as my dad (GP) suggested if I push the boundaries a bit I might improve mobility slightly. I feel a lot better today (emotionally) after getting out. Dad came with me as I have a 3 yr old and we were going to watch 6 year old at a school parade. It was the first time I've driven and first time I've put jeans on since op. I think getting out of pjs and tracksuit pants just lifted my spirits a bit.

      going over bumps in the car was challenging on the external stitches and I did walk very slowly from car to school but at least I got out. I'm on the couch now resting as pelvic bone hurts but it's not worrying me as much since reading all the responses to allow more time. 

       

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    • Posted

      thanks for the recommendation of that book... I feel like I need to see a physio... Feels like I'm all off centre... Like my pelvis is out of whack!

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    • Posted

      Hi Lizziep,

      That's great you managed out for a little while, think we would go insane if we didn't get out fir a while. Hate to say though not sure if your car insurance would cover you as not meant to drive until about 6 week mark as your repair unlikely to survive an emergency stop. Matron use to say if you can stamp your feet without pain should be OK.

      I started with short 5 min walks twice a day and built it up to 2 x 20 min walks by 6 weeks. I don't drive anyway but went to supermarket with hubby and counted that as one of my 20 min walks.

      My first repair was 4 and half years ago and I was much quicker on my feet but not really sure why it failed - many reasons why - but may have just not given enough time to heal in early weeks. Not worth putting health at risk as my sister says it's only a little while compared to the rest of your life.

      Phyl x

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    • Posted

      That's interesting... Dent thunk about car unsurance. I'll call them and find out. Dr said I could drive as long as I wasn't taking the string pain killers that make u drowsy. 

      Im in Australia. Are you too? what would I ask insurance company? My my surgery was all keyhole surgery so no large incisions. 

      So so this afternoon I had terrible stomach cramps and had to go to bed with a hot water bottle and had a 2 hr sleep. I suspect it was from wearing firm shape wear so I could fit into my jeans today. Maybe I wasn't ready to get out after all! 

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    • Posted

      Hi lizziep,

      So sorry to hear you have stomach cramps, hope everything settles down and you feel better soon.

      Best to avoid down pressure until at least 6 weeks then be really careful after that.

      Just take small progressive steps and see how things go.

      I'm in UK so not sure if insurance companies are any different where you are, but at end od day wounds take same time to heal regardless of where you are and you don't want to put any muscle pressure on them while still healing.

      Please be careful it's not worth taking chances it only really a month or two and worth the wait to ensure a successful repair.

      Phyllis x

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    • Posted

      Some of the best online resources about pelvic floor physio are in Australia, as are the therapists who write them.  The website pelvicfloorfirst, Michelle Kenway, and Sue Croft are all from Australia.  The pelvicfloorfirst people also make a simple phone app with pelvic floor safe exercises (once you recover)
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