Slow recovery from rectocele, enterocele, cystocele and puborectalis muscle repair
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I am 8.5 weeks post op for the following: large rectocele, very large enterocele, mild cystocele and repair of puborectalis muscle (not avulsion) which apparently hadn't healed properly after a 3rd degree tear having my daughter 12 years ago!
Op went well, all vaginal with own tissues, no mesh. Surgery about 2 hours. Packing and catheter out the next day. An uneventful 3 night stay in hospital and then home.
The annoying lower back ache i have had for years ans completely gone. And i have had no real pain at all since surgery. No bleeding to speak of after day 2/3 and have been able to go to the toilet fine with no straining (using 1 movicol a day).
What i am struggling with is pretty much constant rectal pressure. When lying down i can feel kind if throbbing/spasm around where i think the puborectalis muscle repair has been done. And when upright and walking there is just general pressure and discomfort. Definitely still have stitches.
Saw my surgeon at 4 weeks and he examined me
laying and standing and was really happy. Also been seeing my pelvic floor physio who is impressed with surgery and cant feel anything dropping down or
re-prolapsing (has checked front and back end!). She thinks my discomfort may be tight muscles and my body adjusting and it all just feeling a but tight for me.
So disheartening as i am really not feeling things improve with regards to the pressure. Had a very easy first 4-5 weeks. starred driving locally at 6 weeks and doing school runs. No lifting, no housework or dog walking. A few coffees out/lunches with friends but all pretty easy. Have been walking a bit but i wouldn't think excessive. Did over do it yesterday with a good bit of driving and up and down alot and can feel it today ...
Do i just need to accept i have had alot
of surgery, stitches still there and this
will take longer than i thought. Surgeon said 6 weeks but no way! Def off work for 12 weeks.
Thoughts?? Anyone had similar?
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NorthSea Bottyissues
Posted
I'm 7 weeks and 2 days post multiple-prolapse repair, (posterior, anterior, cervix/womb) complete reconstruction of (non-existent) perineum and laparoscopic bilateral salpingo-oophorectomy. Like you my surgeons had a very optimistic idea of recovery time (in an early consultation, one of mine said that I could go on holiday the week after surgery!). However, what I've noticed is that gynae physiotherapists take a far more conservative view - and they're the ones seeing the 'fallout' from women doing too much too soon.
As far as I can tell, as long as the surgery has been done competently, one of the biggest risks for failure is putting stress on delicately healing tissues before they're able to withstand that stress. At its most extreme this can result in rupture - the immediate failure of the repair, but this is rare. More common is the weakening or stretching of the tissues before they have healed securely. The effects of this may take much longer to see.
My surgeons continually emphasised the high failure rate of the surgeries I was about to undergo. When I asked what would make a difference to the long term success, they shrugged and said 'we don't really know -- genes?'. I don't buy this. Obviously some factors aren't under dispute: body weight & pelvic floor fitness for example. But as a fit 50-something with a BMI of 22 who is motivated to keep her pelvic floor in shape (I love the Perifit pelvic trainer which uses video games to make a grim task rather amusing) I wanted to know what else I could do. Not one doctor was able to say more than "you'll be back to normal within a couple of weeks".... and that, I believe is the problem. We need to respect the trauma our bodies have suffered and allow them time to heal. As far as I can tell that means a minimum of 12 week for basic tissue healing.
So with all that in mind I think 12 weeks off work is perfectly reasonable. Even desk jobs involve physical stresses (at the moment I'm finding being upright for too long an issue -- I alternate between walking, sitting and being in a 'zero gravity' position which takes the pressure off my pelvic organs / pelvic floor. I'm keen to go back to work -- my brain is there already, but I would need to be teleported to my desk in order to make it work. Actually getting to work is the problem: physically getting to the building, with loos miles away from my workspace (different building!), heavy old doors to pull and push and lots and lots of stairs -- and that's before even thinking about how I can carry a work bag in. These will be challenges 5 weeks from now, but challenges that my body will be better equipped to cope with. If I take on these physical challenges now, I'll get by but at the expense of the integrity of my healing. That's not something I'm willing to risk. That's not something that any woman should be expected to risk.
Best of luck with your recovery -- I hope you'll be strong and fit and well once this is all over.