recticele repair needed now 5 months after TAH, why didn`t doctor find this before ?

Hi, I am hoping some of you will read my story and give me any insights you might have. I will try to condense as much as I can.

I`ve had trouble with constipation for years (from now on referred to as C.) I am 56. A few years ago it got way worse. I had been doing the wait till menopause and hope they shrink thing with my fibroids up till this year. Finally out of desperation I went to a obgyn to ask if the fibroids might have something to do with my C. She took one look at the size of my fibroids and told me I needed to get a hysterectomy. She said it might help with the C but she didn`t know for sure. At the time, I knew nothing about pelvic floor issues, never heard of a recticele. I have never had babies.

About 2 days before surgery, I was talking to a friend who said she had repair work done at the same time as her hyst. "What`s that?" I said. She told me. I called up the nurse at my doctor`s office and asked if I needed any of those repairs. She said, the doc would have checked me for that stuff and besides, then I would have to see a urologist and all that. I felt I was on the conveyer belt going towards surgery by than and being pushed along so I didn`t pursue it.

Well, the TAH went well and it was good to get it done. They took out 4 lbs of fibroids. My bladder works much better now. But I still have C. In fact, 6 weeks after the hyst. I had a bad bout with C. and had a rectal prolapse. I had to go to the ER. My rectum was out about 2 inches. I thought I was finally getting emptied out but it was my rectum coming out. (A little aside here for those of you who strain to have a BM. Don`t do it!! Take stool softeners! I didn`t cuz I thought it might be bad for me. I tried to deal with it through diet, which is good but wasn`t good enough for me)

Anyway, this all led to me going to a colorectal surgeon in Seattle and getting a defecogram and Sitzmark test. He diagnosed recticele and says I have a mechanical reason for my C. He said to have an obgyn do a rectecele repair.

I am going to see my original obgyn and a few others to decide which one to have do it.

Questions I have are these:

Do they repair these with mesh? If so should I avoid that even though 1 doctor`s nurse I talked to said she uses some "new kind" of mesh.

Why didn`t my doctor find it before my hyst.?

I live in Bellingham, WA if anyone knows a good obgyn to recomend.

Please give me any advice you think might be useful and thanks for reading this lengthy story.

God Bless,

i live in washington too but south of seattle, i dont know why your doc didn't talk about your rectocele before hand, that really stinks, i had mine for years (15) before i had it repaired, took miralax and used my hand to "splint" to get poop out. I had mine all repaired during my hysterectomy. I would NOT let them put mesh in for a rectocele or anything else for that matter. Mine was fixed with stitches.

I think a dr sometimes cannot see the prolapse at surgery for hysterectomy. I do not know if they suspended your vaginal vault, but usually they do and sometimes things look allright at that point. In my case, I had three surgeries for uterine prolapse and each time they said the rectocele wemt away. Well, it did not, I had surgery for it last week.

I do wonder however ifit is just a rectocele or a rectal intussusception in your case? With rectocele it prolapses in your vagina and protrude. Rectal intussusception leads to the rectum falling in itsself and coming out ...at the rear. In that case I think you would need a rectopexy, not a posterior repair as that does nit fix the constipation if it is intussusception. At least, that is what my dr told me. I only had the rectocele, not the intussusception, so I am hoping the posterior repairs will last. My dr said my own tissue was strong enough, I had a side and site specific repair. We will see. I had a hysterectomy and bilateral uterosacral colpopecy before that, enforced with SurgiSis.

Hoping to be done now, 7 surgeries in 18 months is wearing me out.

Thanks Laurie, did you have any trouble finding a doctor who would use stitches instead of mesh? And is your constipation better now? Do you still have to take mirilax?

Thanks so much!

Thank you Burned Out! And I can see why you are. I hope and pray for you that you are finally done with the surgeries! What a tough year and a half it has been for you.

I went to a colorectal surgeon who was highly recomended in Seattle and he had me do the defecogram. It showed a large recticele. He felt the prolapsed rectum happening that time was not an issue as I have not had too much of a problem since. It doesn`t just fall out, I do have to really strain(which I was). My PT feels that once the recticele is fixed that it won`t be a problem.

Anyway, I guess I just have to trust his diagnosis but maybe I should get a 2nd opinion. It is hard as I have to travel to Seattle to see a Colorectal doc as there are none here.

Sending hugs to you....



My PT says there is some controversy in the medical community. Some think you should just fix everything. Others think just do what is needed and don`t mess with the rest.

What is surgisis anyway?

I live in the UK and my corectal consultant decided that although I had both a rectocele and rectal intussusception my condition would be cured by a hysterectomy that I had scheduled for a prolapsed uterus and bladder. The vaginal hysterectomy and and bladder repair was done in May 2010 and of course it did not cure my bowel problems , it made it worse as there was more room for things to fall further. I went back to the corectal consultant in October 2010 and he wanted to do a procedure called STARR which I said I did not want because of all the negative things I had read about the procedure. Eventually in January 2011 he agreed to do a rectopexy. I received a pre-op appointment for March 2011 but no date for the surgery, after a month of chasing them I was told in a telephone conversation with the consultant that he could not do the surgery for a further 6 month because of possibe scaring and adhesions from the hysterectomy which I did not believe. I decided I had been messed about enough by him and have now changed consultants and hospitals, which is not easy with the UK NHS. It has taken 6 months to get it sorted but I am now getting it done hopefully in the new year. It is all being done at the same time the original consultant was just doing the rectopexy and hoping it would cure my toilet problems without dealing with the rectocele. The same as he thought the hysterectomy would cure my problems.

They were aware of my rectocele from the start and still did nothing about it. I have had the bowel problem for years and have been taking daily Movicol for 18 months.

Good luck with your recocele repair

Maddie

Yep, I agree, if you have both they need to fix both otherwise your problems will continue. I don't know why they do not want to fix everything in one go. My latest dr said some dr's are a litte wary of doing posterior repairs as it can be associated with painful sex afterwards and such. My dr indeed wants to take a one step at a time approach, resulting in me needing extra surgery. But then I am happy with him also because it means he will not go to extremes such as using mesh if other things can be tried first.

So, this surgery he said after fixing the rectocele the cystocele was also gone (was stage 2, diagnosed by two seperate dr's) so nothing has been done for the anterior wall....we'll see. Trying to heal from this surgery which seems a little harder than I expected (hematoma, fever and such wearing me out). BUT....Bm's are going very well now. Before surhery, no matter how loose stools were, I still could not empty properly. That sems to be over now. Fingers crossed!

Maddie, I hope your surgery goes well, it is still a little while and the wait is annoying especially if you have already waited so long! But, good luck!

Hi Maddie,

It`s kind of hard to have much faith in Doctors isn`t it?

My thought about my constipation issues is that initially it is caused by some kind of food intolerance or allergy. I always tell Doctors that I have IBS type symptoms even though that is a very general term. Eventually I think the recticele formed from straining too much. (I never had babies which is usually the cause)

I feel I have a pretty good handle on my dietary issues now but am still struggling with C. I take Mirilax every day(a stool softener).

I guess my point is that even if I get the recticele fixed I still need to be really careful with my diet.

Hopefully, it will make it all a little more managable though.

I sure share you frustration with doctors though. They don`t really know as much as we like to think they do.

Thanks for your reply, great to hear from your part of the world. (English actors are the best, by the way)

Hugs,

Thanks Burned out,

as long as I do not have to go back to the original consultant I don't mind the waiting. I have put up with it for so long another few months seems not to matter. I thought I had got to the finishing post in March and then had the rug pulled from under me. I was diagnosed with the rectocele about 5 or 6 years ago but told it was not bad enough to treat. I was told to go and forget it as it was just my brain sending the wrong signals to my bowel telling me I needed to go when in fact I did not. In other words the problems it was causing were all in my mind, I just gave up until I could not stand it anymore and went back to my GP. That was over 2 years ago, and I still have the problems, so now I am hoping it will be sorted once and for all.

Sally soo I eat so much fruit I get sick of it but I am scared it I don'y eat it I will have more trouble going. It's like a ritual I have to do every day.

Maddie

Hi I have had a lot of the same problems. I had a rectocele which was discovered right after my hysterectomy and I am sure I felt it all move one day while having a bowel movement. I felt everything shift forward. I also take Miralax. My bladder is still leaky. I have suffered from constipation for years and not straining is difficult but have also found that if it is too soft, then it's hard to pass sometimes. Very difficult to get it right with diet. I eat loads of fruit and try to eat lots of salad. When constipated I find that I can have a bm every day but it is small pieces and never really feeling emptied.