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question about findings on a diagnostic report question about findings on a diagnostic report

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Unread 07-06-2006, 02:22 PM
question about findings on a diagnostic report

I had my yearly with my Gyn yesterday. He had received the diagnostic report from the colon rectal who had ordered the defecography test. He gave me a copy. IT says a
1. rectocele measuring approx. 4cm from anterior rectocele wall to a perpendicular drawn through the center of the anal canal. Later on under findings it says a 4 cm anterior rectocele which does not empty.Does this mean my rectocele hangs down into the rectum area?
2. enterocele distending into the pelvis compressing the superior wall of the rectosigmoid junction. I know what a enterocele is, but what is a rectosigmoid junction?
3. incomplete relaxation of the puborectalis muscle during evacuation. the anorectal angle should be about 180 degrees, instead mine approaches about 130 degrees. Have any of you had this and if so, what can be done?
I had a rectocele and enterocele repair surgery by my Gyn in Jan 05. The report from the defeco then never looked like this one. Can anyone figure it out for me?
I am guessing I am heading for another pelvic surgery.My Gyn told me I have some complex issues going on in my pelvis. This will be my third prolapse surgery since my TAH in May 2004.
I don't understand what is causing me to have such a hard time going. My Gyn said it was beyond his scope, so that is why he referred me to the colon rectal surgeon who ordered this test.
All I know is my lower pelvic area hurts. It feels like it is ripping around my incision area. I hope it gets fixed soon.I have never met this colon dr and it has been over 1 1/2 years. I always seen the nurse practioner. The dr is out on vacation and will be back next Mon. She will look at the test results and my chart, then they will let me know what is next. I hope not more tests!!

Thanks for letting me ramble. I am so tired of this. I still hurt from my back fusion 8 months ago(seeing a PM dr) and this is still going on.
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Unread 07-07-2006, 03:44 PM
question about findings on a diagnostic report

I went to a PT and found out the my puborectalis muscle contracts when it should relax. I just found out that I ahve a rectocele and I had it repaired in March. So ..My PT says that if you dont learn to relax the muscle you will keep getting these cele's because of the straining. She has given me some exercises to do and at her office she helps me learn where the muslce is and how to relax it. I would see about fixing that before you get the repairs, because it might happen again. She said that alot of doctors send them to her first, then they do the repairs. I know how depressing this is, especially you with all your trouble. I am going to hold out for a while, I dont think that I can go thru that now again. I mean it was just 4 months ago. It does make some sense though. Peggy, have you gone to Physical therapist for pelvic floor? You may try that too. it cant hurt and may help you have a BM. It seems neverending, doesnt it? I cannot remember my life before. Sue
Unread 07-07-2006, 08:04 PM
question about findings on a diagnostic report

I have been going to a PM dr for my back. Today I decided to go to a physical med dr instead, so I made a appt. I plan on getting some help for my abdominal area too. My problem is (for one thing) I had stenosis in my back for many years. I had a 2 level fusion and nerve decompression last Oct. I still have nerve pain, which I have had 2 ESIs for and am taking Lyrica . I had my rectocele and enterocele fixed Jan 05. I had no pain sensations post op. I had my cystocele fixed last Sept., which I felt nothing either. I really think I have pernament nerve damage in there too. I feel no sensation during intercourse either. When My Gyn did the internal Wed. I felt nothing. I think if the nerves aren't functioning, then how could the muscles work correctly? I am thinking it is all tied in with my back problem.My PM dr said I have alot of scar tissue all around the lumbar area. He couldn't get through it for the injection.(had to go in through the side) The uro/gyn who did my tvt said I have a whole bunch of scar tissue all around my lower pelvis around my bladder. He had a terrible time trying to get the needles through it. He punctured my bladder trying to go around it. He said it was like cement. I am wondering if I have nerves or even muscle entrapped in scar tissue from my 2 previous vaginal surgeries? I hardly even feel the need to have a bm anymore.During a rectal test the colon practioner did she could not find the nerve in the left side of my rectum down there.I have pain coming from that same side that goes down my left leg. I even hurt in there when sitting down like now.When I push to go I have a sharp stabbing type of pain that goes up into the lower left side of my pelvis area. The dr will be back in Monday. I hope she looks at everything real good and lets me know what needs done next.I need to talk to her. I am so ready to get this over with. I have never seen the dr.I have alot that I need to tell her.I wish she would open up my pelvis and just look at everything and fix anything that isn't right, then my uro/gyn (he works on the pelvic floor with the colon dr)could fix my prolapses abdominally. I want no more vaginal surgeries !!!!! I would then do pelvic floor rehab, along with rehabbing my back.
I have ddd in my spine, so I am so afraid I will have more herniations down there and more nerves compressed. This could keep happening. I already have 4 small herniations in my neck.
I know what you mean by not being ready for another surgery. I've had 7 since my hyst in May 04. I do want this fixed though, so maybe I can go on with my life.
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Unread 07-08-2006, 08:32 PM
question about findings on a diagnostic report


My defecogram results said the same thing about the muscle not relaxing.I think I told you about it in my PM, but the colon rectal doc said I needed to try two things--biofeedback and then Botox injections into that muscle to force it to relax. My insurance won't cover biofeedback so now they want me to try the Botox. He said if the muscle continues like this it will keep causing more prolapses (I already hava a new rectocele) I haven't decided yet what I will do. They are checking with my insurance to see if they will cover Botox, but it does require a general anesthesia to do the injections. Maybe when you see your doc you can ask if they have used the Botox before for the muscle problems. I don't blame you for wanting everything fixed and behind you. I feel the same way and think I am going to insist on getting everything repaired at one time if I have to go through a general anesthesia. Let me know what your docs says once he reviews the report.

Unread 07-08-2006, 09:54 PM
question about findings on a diagnostic report

I am going to ask my PT about the botox. Does a colo rectal doc prescibe that? I have that problem too with my muscle. i find it easy to ahve a bowel movement most mornings, but it is later in the day I have the problem. I am going to try taking the medimucil twice a day and see if that helps too. i dont want to have this happen again. I am going to amke sure my pelvic floor is working before I have it repaired again. I am only 4 months out from last repair. I dont know if it is the same size as before. My original doctor that did my repairs did not tell me this. the doctor I saw in Atlanta told me about the rectocele being there. I thought something was funnny feeling again. This is not what I expected from my tvh. Exactly on year ago. Seems like a lifetime ago. Sue
Unread 07-09-2006, 06:44 PM


I am not sure if other doctors do the Botox injections or not. I heard about it from my colon rectal doc and he said it is basically a trigger point injection--except they use Botox. If you hear of any other info on this please pass it along. I am trying to do a lot of research before I jump into it. It seems like everytime I go through surgery to fix one thing, three other things go wrong! I never imagined having these problems after my hyst either.

Unread 07-11-2006, 05:20 AM
question about findings on a diagnostic report

When I had my Hyst in 2004 I had never heard of any of these prolapse problems. I didn't know anything about them until it happened to me. I wish drs would educate us before they cut us open.I was never told that it is a common thing once the uterus is removed.
When I had my first defeco in 2004 I don't think anything showed up about the muscle not relaxing. Now to think about it that is the exact area that has been hurting me for a long time. I told my Gyn about a poking feeling in there on the left side. He had no idea what it could be. Sometimes when just sitting here I can feel it. I also feel it everytime I go walking. I even get pains in my rectum that goes up the left side. I still have nerve pain in my left leg and now I don't think it is from my back problem. The steroid injections in my back hasn't helped that pain.WHen I push to try to have a bm I feel like something is poking in my lower pelvis. When I had anal rectal testing last year the practioner couldn't find a nerve she was looking for in my left buttocks. She told me then that I had a awfully big muscle in there on the left side and maybe the nerve was just behind it. I think something is d*****ately messed up in there. I don't even get the urge to have a bm much. It doesn't feel like anything drops down into my rectum. I just have alot of gas and quite often it is uncontrollable.
I just want to feel like I did before my hyst. At least I could have a bm. If one would have told me I would have so many problems I never would have had the hysterectomy. I have to go. Just sitting here my left leg is going numb and tingling. It does this all of the time. I had a fasting sugfar test to role out diabetes and it came back real good, so that isn't it.
Hang in there gals. Lets keep each other informed on treatment since we are all three going through the same symptoms. I am still waiting to hear what the dr wants to do. I will not do biofeedback. I think there is more wrong than what it would do for me.
Unread 07-11-2006, 07:03 AM
question about findings on a diagnostic report

Hi - not a doctor here, but I had a problem specifically with my rectosigmoid junction, and the way it was explained to me by my doctor was that is where the sigmoid colon connects to your rectum. If something is pushing there, your BMs are not going thru that passage way very well, thus pain, or other problems.
Does this make sense? You could look up some specific terms on WebMD or do a Google search. I hope this helps just a little!
So sorry for your troubles, sweetie, and I hope they improve!
Unread 07-11-2006, 07:31 AM
question about findings on a diagnostic report

Did your doctor find it when they did the laparotomy? I feel like my stool is geting stuck but not in the rectocele. And whenI have a BM in the morning, the beginning is like a hard ball, all little pebbles stuck together, then smooth. I think it is getting stuck somewhere else. I have pain in my lower pelvic area befor a BM and then after. Christina, who did your LAP? A uro gyn or general surgeon? thanks Sue
Unread 07-11-2006, 07:47 AM
question about findings on a diagnostic report

Yes, that was a finding during my laparotomy. Again, I'm not a DR but, I would recommend this compared to a laparoscopy, if you're going to have surgery. My surgeon told me that this was better in order to see things, obviously, and also to avoid doing any damage to the intestines/colon, especially when you know you don't have any other organs and you KNOW the problem is with your BMs, so most likely your colorectal/digestive area.
Anyway, my surgeon is a urogyn. I felt better with this (first of all, he did my hyst, so he was the last one in there! ) because he knew what was going on, and we felt my bladder was involved too.
Not sure if you've read my previous posts, but findings besides the rectosigmoid junction partial blockage was mulitple herniated (twisted and tied off - no blood supply) loops of small bowel, and bladder cemented to colon. No wonder I couldn't go to the bathroom!
I'd look into this, talk to your doctor - these problems will not go away with medicine or anything. What caused all this? Those dreaded ADHESIONS...I hate them...anyway, one of my herniated bowel things was necrotic, meaning the tissue was mostly all dead and still dying. This could have been bad, they said they got me just in time. Intestinal blockages can be very serious, so you really should probably go talk to your doctor about what's going on. Best of luck, girl!

To all ladies:
I have to say this - I had to be a little agressive and a lot proactive for this to go the way it did. Please don't let your doctors brush you off and say "you just have IBS" when you actually could have an intestinal blockage. This happened to me. Please be diligent about your body, know what to look for which you can find on the internet, and stay strong. This is your body!
Love you girls,

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