Pelvic Organ Prolapse (POP) Expert Forum
Split treatment on bladder side and bowel
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Split treatment on bladder side and bowel

I have been to the Bowel Consultant as directed by my Urogynaecologist.  So far I have mild cyctocele/urethrocele, probable enterocele, possible intussusception and probably bowel bacerial overgrowth.
I have had urodynamics where the nurse could see my rectocele from the outside and so could my Colorectal Consultant who is a General surgeon as well in a teaching hospital over here is UK.  
My rectocele does not protude outside the vagina and he says my muscles are good.

Recommendations so far are that I need colonoscopy, defecography/proctogram, and treatment would be laperoscopic rectoplexy, bio feedback and also if I have enterocele, this would be fixed with mesh as well.

There is a 1% to 2% failure rate which I thought sounded pretty good as they dont go through the vagina.
However..... the cystocele/urethrocele is not something the colorectal team do and the 2 departments dont seem to work together.  If I had all the bowel problems sorted by Colorectal team with no work done on the cystocele/uretherocele how would affect the bladder side and also the bowel?.  Would this approach make the whole of the pelvic area less stable and the cystolele worse?  Since it is mild on bladder side so far and I am exercising do you think I could have work done on the bowel only?

Also, if the bowel was done first then the bladder done on a seperate operation would this be a problem?

When I use my kegel8 exerciser my left leg flinches and my left foot turns outwards by 2 to 3 inches.  It doesnt hurt but I wonder if this is an indicator of anything going on inside and if it is safe to continue.

I presently have a lot of lower back pain and my back, sciatic area and hips at the back feel hot.  I am still constipated now even though using movicol and this seems to be getting progressively worse.  My bowel doesnt seem to want to move.  I find it difficult to sit up for long or stand.

Any and all comments on the above are gratefully received.
Thank you
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A Rectopexy is usually done for rectal prolapse and not generally used to treat a simple rectocele.  The defecography will be helpful determining if the rectum is indeed prolapsing.  If it is not, I would expect your urogynecologist to be able to repair the cysctocele, urethrocle, and enterocele / rectocele.  
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Thank you for your answer.  Urogynecologists dont do enteroceles in Uk, and the failure rate of mesh on rectocele seems a little high if done by Urogyne from what the Colorectal surgeon said.

May I please ask if you have ever heard of a UK urogyne who does all procedures including enterocele?  I am at a leading teaching hospital and the top urogyne doesnt do it.  Any information would be gratefully received.

Thank you again for you help
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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