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Good morning to you all, I have just been for my 3rd pelvic physio session.
I had a proctogram in October and saw the urogynae consultant in December. She said that the proctogram showed a paradoxical muscle contraction and she would not do a re repair while this was going on as the repair would fail again. She would refer me to the colo-rectal team as this was more of a bowel issue than a urogynae. So I'm still waiting of rht ecolo-rectal appt to come through (I'll be on my pension before it does me thinks)
?So off to pelvic physio with the miserable physio to day who is treating me fo rstress incontinence. Unfortunately for her she said that at my last visit I was feeling a bit discouraged and were things better. Well cue a rather long rant on my part here. No I'm not feeling better. This is 16 months since I first saw a urogynae, one failed surgery later and I still no further on. I appreciate that the situation is not life threatening but having to constantly wait 12 weeks between appointments means years of my life are going by with no solution in sight. So..........
?She did an exam of my bowel and feels there is no paradoxical muscle contraction. My pelvic floor is sluggish and does not "let go" quickly enough. I explained I was not, never have been constipated (even though she said the procotogram showed I was - I disagree - unless it's stools caught in the bulge).
?I am to carry on with the pelvic floor exercises - these are the pelvic floor ones not ones for paradoxical muscle problems. Nothing was said about the stress incontinence - but I think I had overstayed my welcome!.
?She feels there is only a very small prolapse. So what the heck is hanging out of my vagina /perineum at a bowel movement I don't know. She doesn't knwo why the surgeon said she wouldn't reapir if I had the paradoxical muscle going on and also doesn't feel this contributed to the failure of the first repair. For me it's not that the reapir failed it's more of a new prolapse - it's in adifferent place.
?She did agree with me that the proctogram is unnatural in that they ask you to strain - which I don't. I splint every bowel movement. But she did say that splinting can cause the puborectalis muscle to contract as I'm not letting the muscle loosen because I'm splinting. Seems to me that it's a bit of a catch 22 situation - if I splint it affects the muscle - if I don't I would have to strain.
?So her top class suggestions are to make a noise like "shhhhhhhh" or "mmmmmmmmmmmm" when having a bowel movement, to sit properly on the loo (I do). Less lifting and carrying (like that's realistic)
?So I have come out in tears yet again - no further on at all. She is going to write to the colorectal team. Apparently the urogynae surgeon hasn't written to the colo-rectal team - well there was no copy in my notes - but I have been discussed at the MDT.
Sorry this is a really long post - just very, very depressing.
On a good note she is going off onmaternity leave so hopefully I'll never have to see her again and shse has transferred me over to her other colleague.
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