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rectocele surgery rectocele surgery

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Unread 09-20-2005, 09:16 AM
rectocele surgery

hi, i am 7 weeks post op from abdominal hysterectomy, but i have recently developed a rectocele
and at my post op appointment yesterday my gyn that did the surgery has referred me to a uro/gyn at her practice who does the repair that i need done so i am looking at more surgery in the next month or so. i have been reading about rectocele surgery and have found that the abdominal approach has a higher success rate than vaginal, does anyone have any opinions on this? i am doing as much research as possiblebefore my appointment with the uro/gyn. also i have been having issues with bladder retention and am on meds for that,
i feel a slight sagging from the top of my vagina and am wondering if my bladder has slipped. does this sound possible? any opinions are greatly appreciated! thanx
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Unread 09-20-2005, 10:12 AM
rectocele surgery

A urogynecologist will be able to evaluate you for any and all pelvic floor problems, and you should insist on it. You need to know exactly what is going on.

I have never heard of an abdominal approach to rectocele repair. These are almost always accomplished vaginally, but some colon-rectal surgeons do them rectally. I believe a perineal approach is also possible. I don't believe I have ever heard of an abdominal approach except possibly as part of a really extensive operation like a sacral colpoperineopexy.

It is true that some surgeons feel that the abdominal approach to other repairs, such as some bladder suspensions and vaginal vault suspensions, have a better chance of long-term success if done abdominally. However, in places all over the US there are other surgeons who are accomplishing those same procedures laparoscopically. (That's not to say it's available everywhere.)

Continue to do your research. The website is very helpful and even has pictures. The UPRISE board deals only with prolapse issues, and there are some wonderful and very knowledgeable ladies on that board.

Best wishes to you. I hope you get the answers you deserve.
Unread 09-20-2005, 12:04 PM
rectocele surgery

hi i had a cyctocele and rectocele repair done all vag. i already had the hyst. in 2003 i had the episiotomy type incision and it was pretty painful (i hope i'm not worring you everyone is different and i had a ton of scar tissue)
as far as abdominaly i have heard of it only on this site.. my dr. said he needed to do it all vag. due to the scar tissue.. i have my post-op on the 27th and i can finally say that today is the best day so far.... for me the hyst, was nothing compared to this! listen to your dr. when he/she says 4/6/8 weeks recovery i really didn't think i was going to be down that long but i am.. good luck and take care..
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Unread 09-20-2005, 12:30 PM
rectocele surgery

Bonniebes, you sound very knowledgeable, do you work in the medical field ? I too have been doing my research and have a full page of questions to ask the URO/GYN next week. I will be having my second prolapse surgery in 2 weeks and have been told it will be done vaginally.

Coffeelover, how long were you out of work? What was the most difficult part of your recuperation? What did you use for pain and how long did you use it? How often do you need to be rechecked by the Dr? Sorry for all the questions but I haven't had my preop appointment yet.
Unread 09-20-2005, 12:49 PM
rectocele surgery

Nope, just a veteran, unfortunately.

Vag. hyst-turned-abdominal due to punctured colon due to undiagnosed and asymptomatic endo in 1997 (hyst was for prolapse). Woke from my surgery to find I had had abdominal surgery and colostomy. When they reversed the colostomy 7 weeks later, I also had a Burch suspension. Almost immediately developed a rectocele (did not have one prior to surgery). Hyst was in Dec. 1997; colostomy closure and Burch were in Jan. 1998

Lived with rectocele for over a year and then had it repaired rectally in April 1999 by the same colon-rectal surgeon who had been called in on my hyst.

Went off my hormones when all the bad data came out a few years back. Now dealing with bladder symptoms again. Trying to manage with Premarin cream but results are not optimal.
Unread 09-20-2005, 12:54 PM
rectocele surgery

Fortunately for me the bladder symptoms resolved after the hysterectomy and anterior repair. I still have a lot of pressure and pain and was hoping that by 8 weeks postop I would feel better than I do. I might as well stop wishing for that since I will have surgery again soon.
Unread 09-20-2005, 01:42 PM
rectocele surgery

I am in the same boat - 9 weeks post op and have a rectocele. I revisit the gyn tomorrow to see what to do. I don't know what questions to ask.

candyapplelady - what type of questions do you have?

At my post-op, the gyn said the rectocele was small. I did what he said and it seemed to improve at first. Over the last ten days, it feels like it has really grown. It is uncomfortable to sit.

I used all my paid leave to take off for the TAH/BSO and now would have to wait until at least after Christmas until I have enough time to take off for another surgery.

coffeelover - I have the same questions candyapplelady asked.

Are there any options besides surgery? The pessary I have read about seems to apply to bladder or uterine prolapse so I don't know if it works for this.

My bladder issues cleared up after the hysterectomy too. Apparently the endo was causing problems with the bladder.

At what point is surgery the only option?

I sure am nervous about this.
Unread 09-20-2005, 02:00 PM
rectocele surgery

There is no reason to rush into anything on this. Doctors say that "most" women who have delivered vaginally have at least a small rectocele. In fact, they don't usually even mention it unless we do.

Yours may have been caused by the hyst or possibly just became problematic after it. That is what happened to me.

Personally, I would not be excited about going back into surgery so soon.

When I complained about mine to my gyn, he thought it was inconsequential. The colon-rectal surgeon sort of left it up to me. He wasn't sure it was causing all the things I was complaining of. He finally said, "let's fix it. It's an easy surgery, and you'll feel better." When he got in there he found that it was much worse than he had expected based on his exam. (Story of my life!)

Best wishes to both of you.
Unread 09-20-2005, 07:41 PM
rectocele surgery

Ifamily, I had A&P repair with the hysterectomy. So far the cystocele and rectocele repairs are patent, holding ok. At 4 weeks postop I felt something bulging at the end of my vagina. The Gyn says it is redundant vaginal tissue, sort of a prolapse in the anterior wall of the vagina. My questions for the URO/GYN are numerous. What type and grade of prolapse is this? How will it be repaired? Will it require grafting or mesh? If grafting, can I use my own skin rather than cadaver or pig? I had a problem with suture rejection, will using mesh cause similar problems? What will you use as suture material since I had difficulty with Vicryl sutures? How long will I need to remain out of work? What are postop limitations? As you can see I'll be with the Dr a long time getting answers to my questions but the second time around I want to be sure I cover all the bases. In answer to your question there is a pessary for rectocele. I never had much luck with any pessary I have used. It did not stay in, bulged out when I had a BM and DH could feel it went we had sex. I felt I was far too young to deal with this for a long period of time and opted for the surgery. I am not sorry I had it done and I do not blame my GYN at all. It seems that recurrences of prolapses are common especially in women who have had hysterectomies. And I have chosen to have the second surgery because the pressure and vaginal pain has stopped me from doing the things I normally do. Good luck with your visit with the Dr. Please let me know how things went. 's
Unread 09-20-2005, 10:06 PM
rectocele surgery

Good luck to you too. I think we are all too young to be dealing with all this -- no matter how old we are!!!

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