Vagina reconstruction & Bowel resection

Hi,

Has anyone else out there had a vaginal reconstruction and/or 'lower anterior resection' along with their hysterectomy? I had this surgery 3 weeks ago and i am having problems with my bowel movements. This was due to a large endo mass between my vagina and rectum.

I would be interested in hearing your experiences.

Kelly
xo

I did not have the the procedures you did but they sound pretty painful! Have you talked to your doctor about your issues with bowel movements? Many people have issues with bowel movements after any surgery involving anesthesia and especially a surgery involving the bowel. The bowel can be a bit lazy and cranky waking up! Also, the pain medications given during surgery and for recovery can often cause bowel problems. Some doctors order specific laxatives, stool softeners, etc. for their patients so you should ask what your doctor's preference is for you. I am guessing your doctor does not wanting you straining right now.

I am sending big s to you! in there!

Hi Kelly What exactly is a "lower anterior resection"? Was it the bowel that was resected or the vagina? Sorry, I am just unclear on what the procedure was.

I had a bowel resection a year after my hyst (so that would now be five years ago). They ended up removing most of my colon during that surgery. Of course I had a little trouble returning to having regular bowel movements; to this day, I still have to take fiber daily and I cannot eat salads because they go "straight through" undigested. I have frequent, very small bowel movements instead of the former, normal one per day. Is that what's happening for you?

s,
-Linda

Hi and thanks for your replies,

I feel like i am getting more on top of things with each day.

Yes doc did give me some laxatives (lactulose) and fibre (metamucil) however these did not give me any relief - i was still waiting 3 days and still not moving. My partner ended up speaking with our local chemist who recommended a product called 'movicol' which is working wonderfully. I take it once a day and end up moving 4 to 5 times a day. Saw my colorectal surgeon yesterday - he wants me to slowly wean myself off over the coming weeks - so i will see how i go. He feels it will improve with time.

Linda, the lower anterior resection - just over half of my rectum has been removed - yes so this means i will be having frequent smal bowel movements - my doc says that over 1 to 2 years this section will stretch and become a little more 'normal'.
They also removed the back wall of my vagina as it had endo all over it - apparantly my vagina has been reconstructed - i will be interested to chat to my gyno further when i see him on the 16th Sept for my post op appointment.

Linda, did they remove your colon because of endo? That sounds drastic!

Cheers
Kelly

(((Kelly))) No, it wasn't because of endo. I had recurrent diverticulitis and my colon perforated and abscessed. The plan was just to remove about 8" to a foot that was diseased based on the barium enema results, but when the surgeon got in there he found that the extent of the disease was much worse than we knew. So, he removed all but about a foot and a half or so.

Did your DR prescribe any sort of fiber for after you have weaned off the movicol? I have to take fiber (I use Benefiber) every day, but yet I can't eat salad because if I do, I'm in the bathroom every 15-20 minutes for a few hours right afterwards. So, it's been a dietary adjustment, which I hear is pretty normal for this sort of surgery.

I'm glad to hear you are doing a little better every day. Keep it up!

s,
-Linda

Hi Kelly, I am new to the forum and was recommended to post in the Endo Support group. Sounds like you have been through quite a bit. I hope your bowels kick in again.

I was diagnosed with stage 4 endo and my right ovary is covered in endo and adhered to my rectum. My surgeon is recommending a radical hysto and rectum resection like yours and frankly I am really scared. I was just diagnosed in December via larparoscopy. In my case though I have endo everywhere, abdominal muscle walls and tendons, ligaments and that is only what they found a in 2 hour search session. I am really scared that once the surgeons get in there that the recovery is going to be severe. In doc is even saying colostomy bag for while during recover . Did you have this?

Endowed

P.S. Also has anyone had MRIs of your torso to see if it was anywhere else. I have a sense that I have it all over. Has anyone any experience with this?

Hi again,

Linda thanks for replying, no salad - that would be difficult - i guess this sort of thing makes us re-evaluate our diets and and lifestyles. Sometimes it's even a wake up call for some of us.....

"Endowed" - i know it sounds daunting, but you will get thru this....

I had my hysterectomy on 9th August 2008 - I had stage IV+ endometriosis my gyno says he had not seen anything quite like it) which included a large mass joining my vagina and rectum as well as endo on my bladder, ovaries, ureter, - it seemed my whle pelvis was a mess. This was discovered by laparoscopy in April 2008. Many biopsies were taken to confirm that it was in fact endo that they were dealing with. (The reason for my laparoscopy was due to increased CA125 levels - this can be an ovarian cancer pointer, although it can also indicate other things such as endo)

I was advised by my gyno that a radical hysterctomy would be the best option and that it may be able to be done laprascopicaly. Upon seeing my colorectal surgeon he advised that he may have to open me up further, depending on exactly the extent of the endo on the bowel. He advised that i also may have to have a colostomy bag for 3 to 4 months while the bowel heals. In the days before surgery had a visit to the 'stoma' nurse at the hospital who explained it all to me and positioned an 'x' on my tummy where the surgeon would site the bag.
Whether you end up with a bag for a few months or not is really a matter of how your surgeon thinks the healing process will go - and how low the resection is once he gets in there. The nurses eased my mind explaining that you can still do just about everything as per normal with a bag- even swimming, running etc....

So after 7-8 hours surgery, my gyno and bowel surgeon removed my ovaries, uterus, cervix and all the endo they could see. I had a laparoscopy plus 2 smaller incisions to the side, as well as having my c-secton scar cut open again for lower anterior resection (removal of an 8cm secton of my rectum). The back wall of my vagina was removed - with some reconstruction work done. I have not had my post-op checks with my gyno yet, at which point i intend to ask lots more questions about exactly how he did this...

I was lucky i did ot have to have a colostomy bag but was advised that if the resection had been any lower i would have had one. My resection was 5cm up from the sphinkster (however you spell it) and they took about 8cm of the rectum (which is usually about 15cm long).
When i feel sorry for myself i just think how lucky I really am to have great surgeons and loving supporting friends and family - and that things could have been worse - had this endo not been discovered it could have gone on to destroy other organs such as bowel and bladder!

I stayed in hospital for 12 days but mainly cos my bowel was slow to wake-up and move.... I had a drain coming form my tummy until i 'moved' (draining from the site of the resection) and a catheta in place for a few days.

All this time my friends and family were getting daily 'poo reports' which they found rather amusing and they were glad i was keeping my sense of humour - which you must try to do for your own sake as well.

It has now been 4 weeks and i am feeling beter with each day, although i cannot stress enough the importance of lots of rest! The days i don't rest enough i end up quite sore and very drained by evening.

I think the bowel issue is a bit of try this and that and see how you go, i think you just need to read your body, listen to it and drink lots of water.

Anyway i just want you to know that it is natural to be scared as i was too.... go into it with a positive mind and attitude. Yes you will be a little sore for a little while but you will cope and each day you will feel a little better. Trust yourself and the power of healing.

Sorry if i've raved on a bit but i thought our diagnosis sounded similar, so i thought it might help you to see how i went.....
Wishing you all the best,
Hugs
Kelly

Kelly,
Thank so much for sharing such a detailed description of your journey. Can I just say that you are a very courageous person. I want to be able to jump in like you but I have been fighting with my surgeon to put this off.

I keep reading a ton of research, combing through Stanford U's medical research library and I keep thinking there must some way of treating this without gutting me like a fish. I don't think I have fully accepted my diagnosis.

My doctor wants to use the da Vinci to perform my hysto and a top oncology surgeon in my area wants to operate on me. I have just been shocked to learn that there is no systemic treatment without surgery available. I bet if there were 20 million men (US stat - 20-30 women million in US with Edno) were at risk of loosing their johnson's there would be some serious research done. I just noticed you are in Australia - hopefully your country cares about women. I guess I am still in the angry stage of grieving this. Well once I set the date for the surgery, you will be an inspiration of handling this well and in a positive state of mind.

I wish you quick and thorough recovery!!!
Lisa - Endowed

Hi all,
I have been reading your posts regarding vagina reconstruction and bowel resection. I am 2 weeks prior to my scheduled surgery. I have had endo for 20 years and my last lap was Jan 2001. I have put it off truly as long as I could-for which I may now pay dearly. I have a mass in my ovary that could be cancerous (only a 1/10 chance--very comforting--giggle). So while the oncologist is opening me thru my emergency C-section scar (vertical) to remove the ovaray for biopsy, he is recommending total due to prolonged Endo. He has already told me that bowel resection is probable. I have been trying to decide whethere to fight the total or have it all done now. After reading posts and seeing what you gals have been thru, seems I need to get this under control now and not go back again. I had severe damage at age 21 & am now 41. I went undiagnosed for years because I have a rare strain that doesn't LOOK like they are taught in school but the biopsy in 1993 confirmed that it was indeed endo. I'm fearful of post op recovery, I appreciate all you have had to say, I do feel better now about going thru with the total. Though I worry that even more then I originally thought, might be affected. Blessings to you all!

I am in the same boat. Age 41 only my stage 4 endo was found for the first time in Nov. 2007 (8 months ago) during a lap (my first one). I had abdominal pain for years, in fact it was much worse in my late 20s/early 30s. I had a chronic appendectomy when I was 20 and when it ruptured to released gangrene into my pelvis. So for years the scaring internally and pain was thought to be from that and a case of IBS.

My husband and I went to see a fertility doc (no pregnancies) and in the course those tests was referred for a lap to see what was going on inside. I had two very large cysts that were play some nasty hormonal games on me, they were removed and found endo growing all over my pelvic region (including ovaries, tubes uterus, in walls of uterus, abdominal muscle walls, ligaments). The rectal resection is because my left ovary is so badly scared from endo that it is adhered to my rectum and to get it off they will likely have to cut out a section. They also suspect that endo is attached to my bladder between uterus. My gyno/surgeon who did my lap said that the only way to get in a remove most of the endo is to remove the cervix up and that way they have full access to the other areas that endo is likely to be.

Kelly it sounds like you had two surgeons, one for the gyno portion and one for the colon/rectum portions of you surgery. I have to ask my docs about this. Again your description was really helpful, thanks again for taking the time to share your experience and knowledge. Honestly just knowing other women out there are in my shoes is sadly comforting (I wouldn't wish this for anyone). So again I hope you healing well.

Good luck to you too Jodi!