Rectocele surgery

I was diagnosed with an intussusception, rectocele and uterine prolapse about 18 months ago that was quite advanced.  An year ago I had a resection rectopexy done by a colorectal surgeon  for the intussusception and six weeks later a vaginal hysterectomy and rectocele repair done by a gyno. (No mesh was used - only dissolving sutures) I continued to have discomfort with my bowel movements and 10 months after surgery my colorectal surgeon has advised me that the rectocele has got worse and he suggests that I have a starr procedure to fix it.  I am aftraid of more bowel surgery.  
Do you think a urogyno - who has specialised in pelvic floor reconstrcution - would be a better choice.  Any comments from you re the next step I should take will be greatly appreciated.  Thanks in advance.

[sherrieP]

Please locate a urogynecologist, I truly feel that is your best bet for long term repair. Because POP is their area of expertise, this is the best bet. A Not all urogyns utilize mesh but about half of them do; in my opinion mesh is the best path to go for long term repair (w/o mesh repairs typically last 2-5 years then need to be redone) but you want someone who is well experienced and understands the proper technique. I'm not that impressed with STARR procedure; it is not utililized much in the states but my sources tell me there are better procedures out there.

Once you are assessed by a urogyn and you know what your treatment choices are, send your questions over.

Sher

[radar7]

Thanks very very much for your comments. Will send any  questions over as they come up.

Just to give you an update on where I am at - saw another colorectal surgeon for a second opinion today. He said his choices of treatment would go in this order (1) try to manage the rectocele by pushing it back vaginally during a BM - he said this works for many woman - but in my case I need to get my vaginitis cleared fully before I can try this (2) the second choice he said would be to get it fixed vaginally - and only if both these fail would he consider the starr procedure.  Said he does not do it himself as it is a more radical treatment and the consequences of the downside is greater..  

So my next step is to see my gyno and get my vaginitis fully under control.   Have an appointment in two weeks.  Will let you know how I go.  After seeing him will see a urogyno also for a second opinion.  Thanks a million once again. God Bless..

[sherrieP]

Most women get frustrated with continually pushing prolapse back inside and needing to insert fingers to have a bowel movement. I would think with intuss as well you'd really need surgery to level the playing field. Yes please keep me in the loop with urogyn opinion, there are better options than STARR procedure. Send questions as you have them.
:)
Sher

[radar7]

Thanks for your comments Sher - yes I must admit the whole idea is a bit off putting - but at the moment I am at a point where I think I will try anything.  

STARR is definitely out now and it will be a vaginal method of fixing.  Will definitely keep you in the loop.  

Thanks again
.

[sherrieP]

You bet!

[nmevhg]

Had repair for rectocele, enterocele and mesh sling for stress incontinence done on Wed 4/18.  Felt pretty good yesterday (Thur) and went home.  Didn't need to wear catheter or bag home.  Am now suffering from constipation.  Have been drinking water and cranb juice, eating fruits and veggies, and have been taking senecot laxative and colace stool softener.   It's only been 52 hours since my surgery.  I'm stopping my narcotic, to my husband's chagrin.  I've read not to use enemas with rectocele repair.  Anxious.

[sherrieP]

Keep in mind that on top of impact of narcotics (I did the same thing on day 3, can't stand how they make me feel, I get wired-went to high doses of ibuprofen instead), your colon needs a bit of time to adjust, come out of "shock" from surgery. Keep up with fruits and veges for fiber instead of grain and push as much water as you can tolerate. You're doing a great job doing the right stuff from the sounds of it. Laxative would make me nervous (addicting to colon) but stool softener a great thing to do. I'm sure in a couple more days things will start to level off. Hang in there!
Sher