i am TAH/BSO 2001, Vag Vault Prolapse w/enterocele 6 wks later. a sacral colpopexy w/halbans culdoplasty was done 3 mths later and last year i had to have the mesh excised. this turned into a nightmare and nearly ended my life. the surgeon perforated my rectum and i had a colostomy to divert the stool, a recto vaginal fistula repair to fix the damage done when he perforated the rectum, a surgery done to reverse the colostomy and a huge hernia due to the diversion excision becoming infected. so, after they reversed the colostomy i began having a small bit of stool leakage and then i had a couople of accidents. i went to a continence specialist and after testing it was revealed that i have a tear in the outer wall of my sphincter. how this happened is anyones guess but now they want to repair it simultaneously w/the hernia repair. my problem is that i know if this goes wrong it's a life sentence of depends undergarments and i am not even close to prepared for that. has anyone had this surgery successfully? has anyone out there had it done period? what can you tell me to look into other than surgery or what should i ask my dr beforehand? any advice would be appreciated.....
I am asking for advice ffrom anyone who has had sphincter surgery i am having problems since a surgery that went bad...the dr perforated my rectum causing a recto vaginal fistula. i had to have a colostomy to divert the stool. then a rvf repair. the incision from the colostomy got severly infecteed and caused a monstous hernia which i am going to have to have repaired with mesh.......which is why i had this initial surgery to begin with. since i have had the colostomy reversed i have been having bowel leakage issues too. at first i would think i didn't wipe well and i'd go back and wipe and then have to do it again. then i had a major accident. fortunately no one was around but i was devasted. i have since had 2 more of these accidents one minor and one major. i went to see a continence specialist in birmingham that did the test and discovered i have a tear in my external anal sphincter between 10 and 12 oclock?? anyway she is recommending that when i have the hernia repair that she also repair this. can you tell me anything about this surgery? maybe enlighten me about the success or of any therapy that might work rather than the surgery? i have had very little success with my surgeries and there always seems to be an infection develop which causes more problems. any advice would be helpful....
Hello, again. I have had an attempted anal sphincter repair that did not go well. My UroGYN is the one who attempted to repair it and was unable to find the ends of the internal sphincter muscle. He moved the fascia to give me more tone and now says I do have more tone. However, since the surgery, my anal incontinence problems are worse instead of better.
What I have done is go to a colorectal surgeon to get a 2nd opinion on whether my damage is reparable or not. She says her success rate with this surgery with people who have damage levels similar to mine is about 75%. What she would repair is the internal muscle. She doesn't usually attempt to repair the external muscle. I believe this is because it has been over 20 years since my muscle was damaged in the birth of my first child.
Since your damage is recent, yours may very well be a far different case. If I were you, I'd go see a colorectal surgeon/specialist and get his/her opinion on the repair. It can be VERY different from what even a very good UroGYN can diagnose or do about it. I've had an anal ultrasound done that shows exactly where the ends of the internal muscle is and even shows how messed up the external one is and why it wouldn't be worth attempting to repair.
My colorectal DR told me that unless the damage is very great, she doesn't recommend surgery at all. Mine falls in the level of 'very great' and she says I'd be a good candidate for the surgery and wants me to schedule it. I am waiting because of several reasons--it's summer and I don't want to be laid up while my kids are home AND I'm sick to death of surgery and long recoveries AND I don't want to stay overnight in the hospital (I truly HATE that). Plus, I want to give the original surgery to attempt sphincter repair at least 6 months to see if things improve to any kind of acceptable level.
Hope this helps you in your search for info.......
Hi I read your other post asking me about the surgery, I had my sphincter tear during delivery of my dd in 1987, I had it repaired in 1988 - so not too much time had gone by. I think that is why it worked for me. It was an unbelieveably painful recovery - sitting was horrid. Now there are much better tests to tell if you are getting any contractions in your sphincter muscle - in other words they can tell if it's capable of working somewhat without surgery. I would make sure that you have them done by a competent Colorectal surgeon and go from there. I wish you the best, fecal incontinence is the worst. As I understand it, once you have had your sphincter repaired, the chance of a subsequent repair working is not good, that is why when I started leaking again (over 5 years ago), I did rectal PT and started doing the warm water enema's (standing) to help make sure I am empty before I leave the house (that was the colorectal doctors suggestion). I don't ever want to have an accident out again, so far it's been over 5 years and I haven't had any more accidents. The rectal PT didn't really help me alot, although I can do rectal kegals separate from my vaginal kegals and I did learn that fiber and eating correctly has a lot to do with my constipation problems. So as long as I keep myself from being constipated, I can 'help' myself empty and go about my day. I am used to it now and I can live with it. Let us know what you find out. HUGS.
Hi Orahdeb and Bowlinggirl --- thanks so much for responding.....I am just so concerned about doing this surgery at all simply because i've read horror stories about it. A colorectal surgeon at UAB is who repaired the recto vaginal fistula and reversed the colostomy. He is who referred me to this woman, also at UAB. She is a uro/gyno who specializes in incontinence, regarding both stool and urine. She did the ultrasound and other tests to check my muscle strength and said everything was ok, although the EMG revealed that my squeeze...was reduced and that I have a tear between 10-12 o'clock? in my external sphincter. I have to have surgery to repair a huge hernia, which she refers to as an immense ventral hernia, so she is recommending this procedure be done at the same time. If I translate this correctly it means a living hell for me during recouperation. I know the RVF repair was extremely painful as it was in the same area. I couldn't sit or get comfortable at all and I may have even had a slight infection. I know the dr put me on antibiotics. The RVF surgery was done in february of this year and the colostomy reversal in april. So is this too long a period of time? Would the external repair be anymore risky? or less likely to succeed? I know I keep thinking that. At present, for the most part I can control this. I would want to kill myself if this surgery turned out badly and I had to wear depends for the rest of my life. I just don't know if this nightmare will ever end. I need a 2nd opinion but I have no idea who I might see as there aren't many qualified surgeons in this area. That's why I drive 5 hrs to Birmingham......Any thoughts or advice to these questions would be very helpful.
Thanks again u2 for all your insight.
stardancer --- hi funny u shud mention that.....i've had back problems for years. usually lower back and sometimes paralyzing. also, i noticed that the back pain would decrease after awhile if my bowels moved. the specialist i saw regarding my back actually informed me that when he has patients tell him that he usually asks them to see a psycologist......i said well doc, if more than one of us are tellling you that it probably bears looking into. there could be a publitzer in it for you....needless to say i never went back
Weird your doc didn't make something of the connection.
Recommending a shrink was way out of line!!! I wouldn't have gone back, either.
Did you ever try another doc to help with your back?
I've heard "inversion tables" do wonders for troubled backs.
Maybe help the bowel problems. You've had more than your share!
I don't know what to tell you other than maybe you should try rectal PT first, a tear can stay that way for ever - as long as it isn't separated. If your muscle strength is good.... I would ask the doctors all those questions you have - plus how bad is the tear? Is it a complete tear or partial? Can you do rectal PT? Do they think it will help/hurt? If I had all this information at my fingertips back in the 80's I would have had more testing done and I really think PT might have corrected my problem, I don't even know if it was separated, torn or what. I just had vague symptoms of not being able to empty (sound familiar - have it again) and pain during intercourse. The doctor swore that it would solve my problems, it did solve the not being able to empty, but I still had the same pain during intercourse - I had to have several minor in office procedures to correct that problem, turns out that when the tried to fix my original episiotomy (I ripped the stitches open a week after delivery), they stretched the skin too far and it would get tiny tears everytime I had sex and thus the pain, I had the whole piece of skin removed. That took care of that.
Good Luck with your hernia repair and hey if you do end up needing the sphincter repaired, I would do it all at once too, you don't want to go through 2 recoveries. Hugs, keep us updated.
I have had a bad back for many years, in fact I am having second back surgery this coming Thursday. One of the things I have had to keep an eye is losing bladder/bowel control. It is called cauda equina. If this happens, there is something like a 48 hour time frame to fix it, otherwise it is irreverible. I have just started having major bladder leakage issues, but so far so good bowel wise. My bladder is not stress related - it is not when I sneeze, laugh or cough, it happens repeatedly, sitting, standing, walking, etc.
When I see the neurosurgeon before surgery on Thursday I will be mentioning the bladder issue. I mentioned it to my physician specialist last week, but will make sure the NS knows too.