Pelvic physio misery and confusion
Posted , 8 users are following.
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.
2 likes, 28 replies
christine58244 trizwizz
Posted
Jan999 christine58244
Posted
christine if you live in the U.K. you are within your rights to ask for a 2nd opinion and your GP cannot refuse. Before you do I would do your homework and check out the urogynaecologists in your area. It has to be a urogynaecologist, that's very important. Check the consultant's who undertake private work because they have to reach a certain standard to work in private hospitals. Then look for their names on NHS hospital websites. Google them and see if there's been any reviews. Good luck
steph16921 christine58244
Posted
Why don't they want to do surgery?
trizwizz christine58244
Posted
Christine - matron is right - you can have a second opinion. Ask you rGP to re-refer you to a specialist urogynaecologist. Do you know why they don't want to operate?
?Pelvic floor exercises won't cure a prolapse but it will make what's there stronger. I am seeing the physio for stress incontinence - though most of the stress I have seems to come from seeing her!!!!!!!!!! - not for the prolapse.
?Are you struggling to go to the toilet because of the prolapse or because of bowel issues - like constipation? I have also been referred to the colo-rectal team as the urogynae thinks this is more of a bowel problem than a prolapse problem. Do you take anybody with you as support when yu see the consultant? That can help as well as writing down what you want to ask. It's all too easy to find yourself being ushered out from an appt then realisign you haven't had the answers to what you wanted. I know because it's happened to me!
Imnotadoctor christine58244
Posted
Agree with Trizwizz & Matron,
I've had a second opinion too. Sometimes it does confuse you more but I think you can't have too much information. Take results of any previous tests (you may be able to fax them to the consultant's secretary beforehand) & write down all your questions!
Good luck.
christine58244 steph16921
Posted
Imnotadoctor christine58244
Posted
Have you had children Christine? I think my problems are partially due to having torn badly during childbirth. I had lots of stitches internally & externally.
christine58244 Imnotadoctor
Posted
christine58244 steph16921
Posted
Imnotadoctor christine58244
Posted
I had an anterior repair. My rectocele has got much worse since then, in fact after a 2nd (& 3rd) opinion I actually need a rectoenterocele repair. My GP is trying to put me off having it done as it will be quite a long recovery time. I'm trying to manage but as I also have IBS it's not easy.
trizwizz christine58244
Posted
A rectocele won't get better on its own. Pelvic exercises will make the muscles stronger though so you will be helping what you've got and stand yourself in better stead for recovery. I had a reasonable pain free recovery from my op - it has reoccurred but for other reasons - the op itself was successful . In the UK it is generally one night in hospital after the op. There is considerable swelling after this op and becuase of this it will feel worse than before - this does go though. Remember you have had some one chopping around and poking fingers where they shouldn't generally be poked! If you can bear to look there are videos on youtube.Rest and wait it out. Don't be tempted to look at your bits and pieces because they won't be pretty! It is a long recovery period and you have to get yourself mentally prepared for that.
?Work out what you want to say to your consultant and write it down. Write the answers down in front of him - this slows things down and makes them realise they can't get away with "medical talk" or gobbledegook- or take someone with you who can do this. You won't remember what is said to you!