Urogynecology Expert Forum
Rectocele?, how to get diagnosis??
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Rectocele?, how to get diagnosis??

Hi I'm 47
Problems started after birth, (5 yrs) low back pain, feeling pressure on inside of spine, some numbness around buttocks & sciatic like pain, bladder irritation & weakness, along with some bowel problems, mostly folding outwards & sore & swollen for a while after passing BM, I do have other weird symptoms GP blamed on stress….. eventually FMS & later M.E diagnosis…. So has taken a long time to get other problems taken seriously.
Problem worse over time, can no longer empty my bowels, without using hands to push a large bulge in Vagina, back to my bowel, often (7-10 day B4 periods) BM are so wide, have to use both hands to shape smaller & pass… easier giving birth ..lol …. takes a long time, up to an hour, leaves me feeling sick, often bleeding, with a sore & very swollen, protruding anus…..which settles later.

I can’t wait to pass BM, need to stay close to a toilet, or in trouble, dizzy nauseous, on verge of passing out, also feeling pressure & tearing pain, & pressure on inside of spine, making back pain, Sciatica & numbness worse
I also need to “rock” back & forth, in order to move stools down, it also feels my bladder is blocked by bowel, as can only urinate fully after BM.
Bladder problems are… stress incontinence, slight incontinence AFTER seemingly emptying bladder, frequent  urination…day & night, again worse pre menstually…often up to 7 times a night, some burning….no infection
I also suffer with extremely heavy preiods (house bound for 2 days

Finally saw Nuero Gynae, yesterday, Outcome was, Physio for slight uterine prolapse, & more test to check Muscle & nerve function of bladder, NOTHING for BM, queried this, & repeated how bad the bowel problem is, specialist shrugged her shoulders & said “can’t see it”
How can I get them to believe this, as only obvious, when need BM, & can’t show them, as can’t leave the house without having passed BM……I’m at a loss, & scared this is only going to get worse, as it has done over last few years…Thanks!!




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242593_tn?1313867921
Hi,
Sounds like you are describing symptoms fo pelvic floor dysfunction, but it appears from your gynecologist's exam, that you do not have severe prolapse. Prolapse refers to a condittion where the vagina is turned inside out, kind of like when a sock gets turned inside out. Prolapse (sometimes called cystocele or rectocele, or enterocele ) can be actually seen easily during a gynecologic exam, and really severe prolapse can actually be seen as a bulging of pinkish tissue from the vagina when straining down during squatting or lying down.

Symptoms of prolapse include difficult defecation, trouble urinating, low back pain, difficulty with intercourse, and a feeling of pelvic heaviness. Many of these are symptoms you are describing. However, many women can have these symptoms without having any significant prolapse. In these cases, the problem can be pelvic muscle dysfunction, specifically, painful trigger points or tightness in the pelvic floor muscles. The way to fix this is with manual physical therapy applied to the pelvic floor muscles by a qualified pelvic floor physical therapist.

So, If your gynecologist or Urogynecologist says that you have mild prolapse, that probably means that you do not have a surgical problem, but one that needs attention by a physical therapist.

Locate a qualified pelvic floor physical therapist (not the "Kegel" kind), and get an evaluation from them. They may be able to help with some of the symptoms you describe.

Dr. Hoyte.
9 Comments
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Avatar_f_tn
im sorry to tell you im pretty sure  you have  rectocele  i had to push back wall of my vagina  to defecate  i know its horrible  but it does work  sometimes i used to think i was going to pass out no energy dont leave house in case of accidents used to stand up and get weird feeling  as if room was spinning  they couldnt see mine either love  i had test and was told it didnt need surgery  but i took it further because  i knew somthing wasnt right i had op  after a lot of tears  and trying to get them to believe me [nightmare]  15 staples and 28 stiches had that done oct 07 had hystrectomy in jan 08 now waiting for op any day now because ive got internal mucosa prolapse  [this is common with rectocele every time i eat it upsets my bowel loads of mucus  please dont suffer like i did there is surgery to correct this i found out the hard way i lost 7 stones in weight  i was a big lass and very happy  now thin lass and soooo fed up   good luck from prolapsedxxxxxxx
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Avatar_f_tn
so sorry forgot to tell you you need proctogram test mammentry studies and a ct scan  if you havent had these test  which you obviously need demand them you know its your body  you also need a colorectal surgeon if you havent had these tests they cant give you a definate diagnosis tell them you have no quality of life if you dont tell them you will carry on suffering needless believe me i know? insist!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
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215234_tn?1305146561
Thank you so much, I just had know idea what to push for next....thanks to you I now do

so sorry you've gone through this too....bad enough dealing with it, without having to fight to be believed....glad you got answers & help though

thanks again :-)
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Avatar_f_tn
im so glad  that you feel as though ive helped you  tell your doc you want that test? where they put paste up your bum  and take xrays while you are straining to have bowel movement  i had this ? and retained the paste this shows it straight away  i dont think your doc can refer you shes the 1 that has to refer you to colorectal when you ask her she will know you done homework ? if you dont get any where the next step is chief executive then they act my prob was gastro saying id got ibs in my head etc nobody should suffer like this  i ended up having blockage  if you need more info id be glad to help  i know what you are going through bless you
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Avatar_f_tn
so sorry i forgot to tell you ? you also  might want to look up  obstuctive defecation syndrome because this is another name for it  i dont want to worry you ? this is not life threatening in any way ? it just makes life extremely difficult it makes you have anxiety and 1 of the symptoms is obssesion  with this disorder  its a good job my hubby went with me because i thought doc was going to say it was in my head you have to be totally truthfull  what went round my head is theyll never find the prob ? also mind wants to do things body says no  good luck xx
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Avatar_n_tn
How often does the doctor review this forum?  Just wondering..............
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Avatar_n_tn
just wondering, I had a defecogram done, and it said rectocele with internal intussusception.  Now two of the colo rectal docs say they dont see it. go to physical therapy.  I went to another and he said resection with recopexy, but cannot say it would help for sure.  went to my uro gyn, he says that he does not see intussuscetion, but would do a sacral colopopexy and fix the rectocele.  Is that the same as what you have?
Sue
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Avatar_f_tn
yes i had the same as you? the rectocele was large the surgeon cleared my bowel out before surgery  because i couldnt ? the procedure i had was starr procedure  its like a staple gun  apparently the device suctions the prolapsed tissue the surgeon then cuts it away then puts your anus back to where it should be  with staples and sutures  but because id got prolapse of womb which in turn caused pressure and a lot of pain in lower spine region  i waited 4 months because all these surgerys can interfere with bowels  then doc sent me for tests all over again  and he said id need it lifting back up kinda like scaffolding i suppose with op called abdominal rectopexy  im just hoping this op works because ive had no quality of life im laid down a lot to try to ease the pain
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J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
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