Anorectal Intusseption?

[lindale]

I had surgery in October for a fairly large rectocele.  After the surgery the rectocele was not completely dealt with, and I ended up having a second rectocele surgery done in February.  I now no longer have a rectocele, but still have the same bowel issues (actually worse) that I had before the surgeries.  I still have a pocket in the last inch or so of my rectum about the size of a golf ball where BM continues to get trapped, but now I cannot even push on the area through my vagina to completely empty my bowel like I could before the surgery in February.  The stretched out bowel is bunched up above that pocket and seems to telescope down from further above. When I bear down it feels like it almost completely blocks my rectum, and many times is quite painful. My BM comes out in “ribbons”. If my stool gets in the least bit formed it is extremely difficult and painful to pass, so I have continued taking Miralax and take 2 Colace twice a day, as I was told to keep my stool no thicker than toothpaste.  Even with this amount of medication I still occasionally end up with hard stool that I cannot pass, and end up using a finger to pull it out.  I do not imagine that is the best thing for my rectum.  When I went for my 4 week post-op my urogyn said there was still a lot of swelling that was affecting my rectum and did not seem concerned about these issues.  It is now 12 weeks post-op, and I have not seen any improvement.  Is this normal?  Is it possible that the bowel tissue will shrink this long after surgery, or could I need colorectal surgery?  Do you have any suggestions?

[lindale]

What happened to the expert?  How long does it take to get an answer?  My bowel is getting worse by the day, and I think it is getting close to prolapsing.  The posterior wall was holding up, but now it has gotten pulled down slightly by the pressure.  I now have a 360 degree intusseption that is getting slightly past the dentate line on one side, but so far not protruding.

[lindale]

Just as a follow-up to my question about anorectal intusseption:  I have had bowel issues since gall bladder surgery in 2008, with severe diarrhea and bouts of incontinence.  This resulted in a full thickness rectal prolapse in March 2010, which was successfully repaired by rectopexy and anterior resection.  My general surgeon told me that my bowel was significantly stretched out probably from my 4 pregnancies.  He removed approximately 12 inches of that stretched out section of bowel.  In June 2010 I had a cystocele and incomplete uterine prolapse that also caused significant internal hemorrhoids in an existing anal fissure. The prolapses were repaired by uterosacral ligament suspension, para vaginal defect repairs, and a Burch procedure done by a urogyn at my own hospital.  The rectocele developed rapidly following surgery, and hemorrhoids became extremely painful. Although all I wanted repaired was the rectocele and hemorrhoids, the urogyn from a teaching hospital did supracervical hysterectomy (against my will), and both anterior and posterior colporrhaphy, which did not resolve the rectocele.  A general surgeon did successful concurrent surgery for the hemorrhoids.  My neck was significantly injured by excessive hyperextension while performing intubation.  Since that surgery I have serious cervical issues and a return of stress incontinence that had been successfully repaired by the previous Burch procedure.  I have also had significant sexual dysfunction as a result of that surgery.  When I went for the second surgery (same urogyn) I refused to allow any stress incontinence repair, as the slings are notorious for failing or causing more problems than they resolve.  The rectocele was repaired, but the stretched out bowel was simply pushed into the bowel and left there.  Now I have more problems with BMs than ever before.  I have an appointment to talk to my pcp tomorrow, and hopefully something can be done!  My life has revolved around my bowel for over 3 years now, and I just want my life back!  

[cricket3991]

sounds like your surgeon is not very good to have to do it twice and then still not get it fixed.  I would go to another dr. for a consult.  I had same surgery last of dec. and no problems with bm's.  It messed up my bladder as he put a sling in and I can't always empty completely.