rectocele repair fail - sort of

Well......... I went to the GP originally thinking I had a rectocele - good old DrGoogle! - The GP felt the rectocele was large - greater than 4cm and there was also a mild cystocele and referred me for both. The consultant felt that the rectocele was not as big as the GP thought.

?I had an appt with a GP for something else and saw a different GP in the practice, not the one who diagnosed  the rectocele and asked him about the disparity in thought of size. This GP felt that it may be because the consultant sees rectoceles everyday, whereas the GP doesn't, the amount of waste in the rectum etc.

?The consultant sent me off to urodynamics clinic for incontinence tests and flow tests. I think the flow tests also can see the amount of bladder prolapse due to empyting/not emptying. That came back with stress incontinence. After the surgery the surgeon said there was no cystocele. So at the post op the consultant offered me a TVT for the stress incontinence rather than an anterior repair for a cystocele. I turned that down for the moment - can't face more surgery and he was going to refer me on for physio with a recall for possible surgery in six months after physio to see if it had/hadn't worked.

?The new prolapse is a posterior one lower than the original. It is right at the edge and I think if done will involve the perineum - but I don't really know this.

Sorry meant to add that I know the bladder itself can't be seen but the prolapsed bit. I felt at the post op he was more concerned with the bladder bits than the repair. The repair had healed well and had caused no problems at all so there wasn't a lot to see really. He didn't ask me to bear down or do any of the things he asked at diagnosis, even though I had said there was still a bulge. He checked the wound sight for a bulge and of course there was none as it's not there! The new bulge more sort of comes and goes at the moment - just as the original rectocele did at the start before being permanently there!

?When I think back to about htis time last year I noticed things were not  quite right. Just a thought of "that's odd" when using the loo. Then there was a time when it all 'broke through' and was there permanently. I never knew rectoceles existed until then. I'd heard of proapsed bowels but always presumed they came through the anus/rectum rather than the vagina.

?That's why, now I know these things happen, I want to get this one sorted before it becomes a big problem! The new bulge is there when I bear down/go for a bm. Not hangng out permanently at the mo - I think!

Hi Trizwizz,

Sorry to barge in in the middle of a thread. I also have a low rectocele, I'm going for a second opinion with a urogynaecologist to find out what can be done. At the moment I find BMs difficult unless I push against my perineum (sorry!). I saw a colorectal surgeon for my bowel problems and he agreed to repair it but would do it rectally. I don't want this so am seeing someone else as my anterior repair may have partially failed so might need doing at same time. I was told it was ok to repair a low rectocele. It's not that big but because it is low it feels big to me also I worry about the pressure on my already weak perineum. I will let you know how I get on if you like? It's so good being able to talk about this.

Not barging in at all! That's interesting infromation. When I first discovered all this I never thought a prolapsed bowel was something that was repaired vaginally so all this was new to me. Actually had never heard of rectocele eiither always thought a prolapsed bowel was through the rectum/anus! Yes over the last week there has been a marked downslide (literally and figuratively) today was terrible. I desperately need to go to the loo  - have tried about three times to have a bm - pressing against my perineum too. Not totally successful as feel only partly "evacuated." really not nice. May have to resort to laxatives tonight  - not because of constipation but to build up a "head of pressure" as it were to get everything out!!!!!! Really no tideal as I don't lie using laxatives due to long term effects etc.

?Yes I know what you mean about it feeling big - I'm sure it isn't - is just the positioning of it. It's worse in that sense than the other rectocele. It was my GP who said he felt it couldn't be repaired. But his main interest is in bones/arthritis etc not gynae. If it does need repair I will ask him to do the TVT as well. When is your next appt? I will have to wait for mine - I'm ok about that - well not today due to bm problems  - but in the main I'm ok. We are away next week which I'm looking forward to.

My consultant told me to use Fybogel rather than Laxido which my GP prescribed (in fact he wrote to GP as he was quite cross about it!) We are all different but I find it is best for me. I only use it occasionally. I'm having control issues (maybe because rectocele is low?) if my stool is too soft. I've got to the point where it has taken over my life and I worry so much about work/going out/holidays etc I have to make myself do it or else I would never leave the house.

Never in a million years did I think I would be talking to people I didn't know about my undercarriage and poo!!! But I really think it is the only thing keeping me sane ??

Appt is this week so I will report back with any news. Have a great holiday. X

Hi hon. So good to know I'm not the only one having poo problems after rectocele surgery. I'm now just over 3 months since op and pain in back passage along with extreme difficulties emptying bm. I'm now worse than before surgery. Sitting all day is making me ache but if I take painkillers it makes bm more difficult. And back on lactulose. Why did you mention to you fibre gel? I try avoid straining but it's like muscles aren't working! Do I need to see GP for another referral to hospital? My surgeon doesn't do post op checks!! Good luck to you on this horrible journey & thanks for sharing your problems. Don't know what I would do without this support forum. X

Hi Jojo

Sorry, perhaps I wasn't being clear. I haven't had a rectocele repair yet my bowel problems have started since my anterior repair which made my rectocele worse.

I'm hoping that a posterior repair would solve my problems but maybe not?! I'm sorry to hear you are not feeling better.

My consultant suggested Fybogel as it is a 'bulk forming laxative' rather than a 'stool softener' which was better for me.

It seems wrong not to have a post op check I would think you should be checked just to make sure everything is healing well.

Post surgery i was prescribed lactulose and movicol together for two weeks. Constipation has never been an issue for me. I am careful with what I eat though and have lots of fruit and veg etc. This new rectocele is worse in that waste matter seems to be more "stuck" rather than pocketing in a bulge as it did before.

?Imnotadoctor - I think this is why the surgeon I had didn't like to do the two repairs together as he feels that one can become worse or better following an op so prefers to do them separately. I can see the reasoning. An ex-colleague of mine had the same surgeon and has had a posterior, anterior and hysterectomy done. I can see why but not sure how work would feel if I had all this done separately!!!!

?I will say the posterior repair I had done was successful. I had no pain really and it has healed well. This now seems to be the problem. it has exposed an underlying weakness further down which has now "popped!"

jo jo - I have never heard of somebody having no post op after this type of op ( sorry that may be really bad grammar but I hope you know what I mean!) For me it was worth going back to the GP - I know him better - and I felt he listened to me more. He got up pictures of prolapses and asked me to show him what I meant then said "the only way to tell is to look" so he did a thorough examinatiin and decided I needed a re-referral. So it was worth it.

Yes, it seems once you have a weak pelvic floor then it one thing seems to follow another. I had 2 difficult childbirths (years ago) and I think where they had to sew me up some damage was done. Sadly once you reach the menopause it comes back to bite you on the bum (if you will excuse the pun!) They don't tell you all this in the antenatal classes!

I'm trying to keep positive about all this but it's hard sometimes. At least I now know I'm not the only one.

Ridiculously both my children popped out! I did have them 14 yrs apart but no problems with pregnancy or labour. I had a very minor perineal tear - two or three stitches I think. No pain relief and over in a few hours. Yes I was lucky. I have entered the menopause radically post op. Literally the day they took the packing out I started hot flushes. I have gone from normal hormone levels to being half way through menopause in less than 4 months. The surgeon says it's nothing to do with the op - I think it's more than a spooky life coincidence. But that can't be changed so it's onwards with menopause.

My surgeon told me "any mucking about down there brings your menopause forward by 18 months" He was a very straightforward man but very good. I was advised to start Vagifem about 18 months after the anterior repair and am still on it. I had the occasional hot flush but not too bad. X

That's interesting. I saw a GP - no tthe one I normally see  - and he said that the shock of surgery could have brought it on. Especially due to my age - I'm nearly 53. I think this is true. I had no signs before and the GP told me my hormone levels from before and after. My hot flushes have subsided a little. They've gone from "spontaneous combustion" level to "hot glow" !! A little more cope-able with now! Just had my first - very light - more spotting - sort of period since the beginning of April.  But wilh none of the usual pre-menstrual symptoms from before. Hopefully as it started quickly it'll be over quickly!

Thanks. I'm just feeling really down at the moment. Each week seems to get worse rather than better. The pain is getting me down as I had been coping well. I went back to work at 6 weeks post rectocele and now wish I hadn't. Even though I've been careful I'm convinced something is definitely wrong and worse now than before surgery. Another trip to Gp needed for a follow up referral.