Posterior prolapse, again.

Yes. Sorry original post was so brief. I thought it was meant to be a few details and then I'd have chance to post in full! Easy to see I'm new to this.

To sum up, diagnosed with anterior and posterior prolapse ( described as bladder and bowel prolapse by my doctor) in March 2014. Consultant confirmed this 2 months later. On NHS waiting list till op in February last year. 

After op I had absolutely no abdominal pain at all! It seemed miraculous and I felt so well. I was careful not to lift heavy weights etc, but went walking as soon as I returned home. 

However, late last June, while on holiday, I had the familiar old sensation and my doctor confirmed on my return home that my bowel had prolapsed again. She was never over optimistic about this part of the op, saying that it often failed, and indeed asked me if I was sure I wanted my name back on the lengthy waiting list. I said I did.

Now back to square one. I'm slim, eat a healthy diet, yet, at the age of 67, feel at times like an old woman. I know that the problem originated with the birth of my first born when I was left with horrendous piles that lasted for weeks. Since then, in 1973, I've always had a " loose" sphincter which slightly protrudes. Now my bowel motions are erratic. Sometimes there's no initial problem, but during the day, especially if standing is unavoidable, I feel the weight against my sphincter ( hope this is correct definition!) and an urge to pass a motion. Often there's nothing to pass, but I have to push it back up with paper and either lie down or sit till it feels normal again. Sometimes there's only a tiny motion yet it brings relief, and at other times a series of " bubbles", as opposed to passing wind, also helps.

I work occasionally as a supply teacher, though basically retired, due to financial problems, and this is becoming increasingly difficult.

Should I stay on waiting list for a further op, or is it likely to keep occurring? 

Sorry if that was overlong, but I do appreciate any advice you may offer.

Hello again Tats. Firstly I'm surprised by your GP's comment about a rectocele repair and her not being optimistic because it is a very successful operation. I had the operation 6 years ago and like many women everything is ok. Secondly was your surgery performed by a urogynaecologist as opposed to a gynaecologist because that is extremely important to increase the chance if success. You've explained your symptoms very well and they are typical of a rectocele in extreme cases. I know just how awful they are and I don't blame you for wanting another repair. You've already done well preparing for this surgery by losing weight. If you aren't already do your pelvic floor exercises because although they won't improve your rectocele they will help strengthen the muscles to give more support to your repair. Other ladies on this forum will respond to you and share their experiences. Just to mention about your bowel motions, have you tried putting your feet on a stool whilst sat on the loo? This helps the stool evacuate and may help clear the bowel a bit more successfully. Please keep in touch x

Tats I forgot to say. If you click on Genitourinary Prolapse at the top of this page (in red) it takes you to the forum home page. There you'll find lots of information under the heading Useful Resources. The information has been put together by myself and other ladies on the forum as well as Alan (Emis Moderator). It's all well researched and up to date. I just thought you may find it helpful.

Many thanks for such a speedy and helpful reply! I clicked on Genitourinary Prolapse as recommended. Very interesting, and I was able to offer advice to another post op patient!

My op was performed by a gynaecologist .

I found post op info to be very brief and lack specific detail. Even at my 10 week follow up consultation I had to ask all the questions I could think of!

Will take advice on board re using a low stool and the dreaded exercises....had no idea so many repetitions were essential!

As for weight loss, I didn't have to lose weight as I'm one of the lucky ones whose weight is stable! Think I deserve some luck!

Final question. I've heard so much about the awful pain that can result from the use of mesh and I'm worried that as my first operation failed, this might be suggested. Should I be worried? 

I live in N. Ireland where the waiting list just for a consultation can be a year, so I've plenty of time for exercises!

There's a lot of controversy around the use of mesh and it's not used in Scotland and the USA because of the concerns. The mesh that's used now is a different type and although I didn't have mesh inserted I would confidently agree to it now. The Royal College of Gynaecologists dealt with the concerns very quickly and the use is very carefully monitored. Only a limited number of Urogynaecologists are allowed to use the mesh so if your consultant is a Gynaecologist he won't be registered and you won't be offered it. It is extremely rare for a gynaecologist to perform a prolapse repair most operations are performed by urogynaecologists and if I'm honest I would only allow a urogynaecologist to repair my prolapse. The reason being is that they undertake intense specialised training usually a minimum of 2 years after they become a gynaecologist so the training is long and not all gynaecologists pass. As this will be your 2nd repair personally I would be asking for a urogynaecologist.

Thank you yet again for both reassurance, and advice. Perhaps I should backpedal and check surgeon's credentials again. I was on the waiting list so long that I was sent to a private hospital, but costs covered by NHS, so I was so relieved that I didn't check out his actual qualifications. Will give it a go and be forearmed for next time.

If you can't find out if he's a urogynaecologist, send me a personal message with his name and your health trust/area and I'll check for you.

Wow! Please tell me you don't work 24/7 !!

His name is Dr. Ramez Ayyoub, Consultant Obstetrician and Gynaecologist.

NHS practice at Ulster Hispital and at Kingsbridge private hospital ( 3fivetwo Healthcare)

No I don't work 24/7 😂 I'll check for you

Tats I don't think he is a urogynaecologist. His speciality is obstetrics and general gynaecology, a clever man but he doesn't seem to specialise in prolapse. You may not be referred back to him of course and you are entitled to see who you choose.

Thanks for effective research! I'll Bear all advice in mind when/if I get appointment! Have a nice evening.

Thank you so much for interesting facts! I've never even heard of a paradoxical muscle. It just shows how uninformed we patients are before an operation. I know doctors and consultants are rushed off their feet, but it's so frustrating to have to guess what might happen and try to anticipate it!

Your mention of a colo-rectal team has also made me thing of finding out omore. My current discomfort is associated more with my back passage than the feeling in my vagina...I can cope with that. I also wonder why I was examined horizontally when the problem starts when I'm upright!

I've no idea why my repair failed as have still to see a consultant! Personally, I feel that as my post op was so painfree I'd no feeling of pain if I did something inadvisable, so was unaware when I did too much. Perhaps I'll never know, but I do feel happier knowing there are so many women who have similar problems!

I do hope your appointment comes through soon. Good luck, and thanks for replying . X

Hi, your symptoms are very similar to mine & I completely understand how horrible the bowel problems are. As I've previously had an anterior repair (which has partially failed) my GP is trying to put me off having more surgery. I need a rectoenterocele repair, I have seen a urogynaecologist & a colorectal surgeon. Obviously a colorectal surgeon would approach the repair from a different angle which I didn't feel comfortable with so I would definitely go with the urogynaecologist although I still haven't made up my mind what to do. I'm 13 years younger than you & feel I have a lot of my life to live so need to get something sorted! Matron is right about using a little step in the bathroom it really does help.

My GP is male & although he's nice I don't think he really understands how it feels to continually have this pressure in your rectal area. It's great to have this forum, I wish this subject was talked about more as it seems to affect so many women. Good luck.

Thank you for helpful details. I can't believe such a forum exists where women are so willing to respond. If only I'd known about it before my operation I think I'd have been in a better position to question aspects of the op, and possible post op complications/queries. 

Not enough females performing gynae ops so we're left feeling helpless. 

A big thank you again. 

Hi Imnotadoctor! Nice to see you here! You are totally right, doctors don't understand how we feel. Mine is nice but in my last check I could tell he was a bit fed up of my questions... I'm 3 weeks post op and still feeling that I don't have normal BM... sorry to change the subject! I'm quite alone here in Spain it seems I'm the only woman that have this problem! Here nobody talks about this! And if they do in forums, they are not trustful like this one. Thanks to you, Matron and the other ladies I'm a bit accompanied in this way....

I was wondering how you were! It's still early days but I can understand your frustration. Hope things improve for you soon. Xx