Urogynecology Community
facing rectocole surgery
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WELCOME TO THE UROGYNECOLOGY COMMUNITY for WOMEN: This Patient-To-Patient Community is for discussions relating to Female Incontinence and Pelvic Floor disorders such as, Cystocele, Drooping Bladder, Intercourse Pain, Pelvic Organ Prolapse, Vaginal Relaxation and Vulvodynia.

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facing rectocole surgery

I'm 65 years old and have been told I need rectocele surgery.    I have had it for 4 years and can deal with it.   My eating habits were terrible but now I take Perdiem and drink fiber and lots of fruit.  I have bowel movements and do okay.  I do have hemorrhoids and saw a dr yesterday and he didn't seem too concerned about them.  Said it was just outside tissue.  Sometimes when I do get constipated which I have had most of my life I get vaginal irritation from the rectocele which is the only reason I went to the dr.  I thought it might be yeast but I cleared it myself.
I had a partial hysterectomy and bladder suspension 15 years ago with no complications.   I am absolutely terrified of having the rectocele surgery.   I've been reading about it and read too many stories about complications afterwards and causing more problems.   Just that it sort of complicates things.  I live alone and have no one to help me with chores or shopping.  
The gynocologist said she would use the mesh method.   Please help me.   I am so scared and full of anxiety.
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I'm so glad you are doing some research rather than jumping right into a second surgery. I've had POP surgery for rectocele, enterocele, and cystocele so I understand your anxiety at this stage. First of all, if you are comfortable with self-treating as you have been doing all along, there is  no need to have surgery; this should be viewed as a choice not a necessity. Millions of women have POP around the world, there is no right ot wrong with having or not having surgery. There are quite a few treatment options available, the first that comes to mind in your situation is a pessary. Did your physician discuss this with you at all? Many physical therapists assist women in their choices of treatment as well. I highly recommend seeking the advice of a urogynecologist, this is the specialist for POP and they are familiar with all of the structural complications of POP surgery. The risk of complications is highly reduced in my opinion when surgery is performed by a urogyn. Many other physicians do types of POP surgery but what happens if you actually have more than one type of POP when they go in and they are faced with addressing a situation they are not prepared to repair? You certainly do not want to have another surgery. A good urogyn will not force the issue of surgery, they will guide you with the choices of surgical or non-surgical treatments that you are most comfortable with.

Yes the heal curve can be long for some types of POP surgery (mine was 12 weeks but I had 3 things fixed, 2 of which were quite bad); I've never regretted my decision to go ahead with surgery for a second. But if treatments work well for you and you live alone, it sounds as though non-surgical is the way to go. Pessary, Kegels (but you have to do them right), core strengthening like pilates or pfilates, HRT if you are not using it to build up the muscle tissue integrity (and if there is irritation in the vagina, I have to ask-have they checked your hormone levels-if there aren't any cancer issues, some vaginal estrogen may help with that irritation issue), biofeedback, electrical stimulation, support garments-many tools you can utilize to help the situation. Women often use a combo of these treatments.

Do not push forward with surgery, push forward with finding an option that is comfortable for you. This should be about what makes you most comfortable, too many people feel pressured into surgery because a health care professional recommends it-explore your options. If you don't know how to locate a urogynecologist, give me a shout and I can guide you.

Good luck!
Sher
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Oh thank you so much for your reply.   I saw my gynocologist today and Monday her nurse will call with the date which will be in Oct.   Yes I have tried the pessary.   Sometimes when I put it in I would feel pain in my back or side area.   And I came down with a yeast infection within a month.   It would come out with bowel movement.   This dr. did my hysterectomy and I know is a very good dr and surgeon.
I told her I deal with it but when constipated it bothers me and sometimes I get irritated in the vagina.  I asked her if it could get worse and she said yes it could.   If I put it off at my age the surgery could be more difficult and complications.  She is the 3rd dr I have seen this week and all recommended surgery.   Now one thing, I ask her about possible infections and risks and she said she had never seen it.  ?????  She said this surgery is minor compared to all I've had.
I'm so full of anxiety I think I could explode.   But guess I will go through with it.  Just hearing from you is so good.   Thank you    Please stay in touch with me.
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My surgery is scheduled for next week.   I am so nervous about it.  I have had surgeries but this surgery is scary to me.   My gynocologist will do it and I know she is a very good dr and surgeon.  I just don't know what to expect afterwards.  She will use the mesh method which I have read good and bad about.   She really didn't give me much information.  She just said is is a minor surgery and nothing compared to what I have had.  I've had gallbladder, bladder suspension, partial hysterectomy and partial facelift.  
Also I would be in the hospital for one night.  I suffer with constipation most of the time and afraid of getting constipated afterwards.  I think doctors hear this so much they don't take it very seriously.
I live alone and don't have anyone to help me.  I am 65 and in fairly good health.   Pleae any replies will be greatly appreciated.
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Hello, I just had rectocele surgery. You will need someone to help you after you come home from hospital. I am fortunate to have a husband and (family near by) and I couldn't have done it without them. I hope you can arrange this for your well being.
I too was very scared but it turned out well. I am VERY glad I did it! I had to go home from hospital with a urinary catheter for 5 days.This was distressing to me but the nurses were very kind and I managed it. If your doctor is good, she will keep on top of constipation issues for you. Enemas may help and it is better if someone can help you with those. Much better results!

Again, I did not have mesh. From my research, it seems about to be 50/50 for mesh or no mesh. I found no compelling arguments to weigh either choice heavily in favor or not. Since my doctor had already had the surgery herself ( one of the reasons I chose her!), she preferred no mesh. So, I went with her. I liked her very much for a lot of reasons.
She is is a gynecologist and has done hundreds of these surgeries.

I did get another opinion (2x), one from a male URO-gynecologist. He seemed an excellent "engineer" and  textbook expert on female anatomy but precise technique wasn't enough for me. He blew off any attempts to discuss the role of constipation,either pre or post-op. That alone was a deal breaker! Plus he was so focused on how he was going to cut and patch and move things around, that I felt forgotten as a person. The man may know vaginas from a surgeon point of view but there was no "heart" to his knowledge.
As someone else summed it up - I went in looking for new refrigerator and he wanted to remodel the whole kitchen.
I hope by now you are hopeful and relaxed. Take care and please feel free to write.
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I have to apologize for not getting back to you with more info sooner, missed the replies. I'm glad pomponette sent in some info for you. I have a ton of mesh in me, no problems at all but I did ask lots of questions about it prior to surgery.

Since you are past surgery I will toss in some info from that angle. Know that the feeling in your rectum will change as you flow through the heal curve. I remember at one point thinking how "hard" the tissue felt inside the area and that is normal-it softens up with time. Important to eat foods that will make elimination easier for a while, think fruit for fiber rather than grain. I find canned unsweetened pineapple works pretty good for me, Activia yogurt (cherry is the best!) works pretty good too. Most important, do not lift, push, or pull anything until your dr releases you to do so. It is so important to get healed up completely b/4 you go back to  normal activities.

If you still feel discomfort at this point, a heating pad (I love the bean bags you can heat up in microwave, no cords to deal with and they are so soft and flexible, you can shove them in your crotch area) does wonders when you are sittting on the couch at night watching tv.

When you get a chance give me a shout and let me know how things turned out, again I am SO SORRY I lost site of this post-too much worky, worky....I hope things went smoothly for you!

Sher
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I'm not feeling so good today.  It seems as though my dr. was through with me when the surgery was over.   I couldn't see her yesterday because she was delivering babies.  Probably my attitude is because I'm just tired.

The thing with having a bowel movement is wearing me out.  I eat fruit and fiber and take stool softeners plus Perdiem.  Now it seems as though my hemorrhoids are getting worse.  I too feel the "hard" feeling you said you had with the tissue inside.   I know you are younger than me but how long did you think it took you to heal and be normal.  I know I will be on laxatives because drs had me taking them everyday long before surgery due to the rectocele.   The surgery was Oct. 14th so I'm going in to the fifth week post surgery.

I did have an appt with dr yesterday but when she is at the hospital delivering babies I couldn't sit there and wait.   Then I had car problems and was on my feet longer than usual and got overly tired.   I stopped wearing the mini-pads as the bleeding has stopped.  I think they were causing irritation on top of everything else.  

Forgive me for being down but could you just let me know how many weeks or months you think the healing process is.   I'm still glad I had the surgery and feel the long run will be positive.   Sure don't miss the bulge and discomfort of it.  I'm doing my best to think positive.   Thanks!
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I am so sorry to hear about the followup on your surgery, this is inexusable as far as I am concerned. The main reason I always recommend urogyns for surgery is there is less risk for complications. They seem to follow up on patient care after surgery the best. I can remember calling to talk to the nurse practioner in my urygyns office a few times after my surgery. The outcome of POP surgery of any type is always enhanced by the quality of followup care.

I know you went into this surgery with a good feel for your gyn, but I truly feel it would be a good idea to get a consult from a urogyn if possible. Any physician who recommends you take laxatives every day is not the physician you want. Our bodies do a good job of maintaining if we do the right things. With a rectocele there is no gettting around the constipation while you have the rectocele, but taking laxatives continually is never a good idea-the body gets used to them and needs to have them to eliminate. You want your body to do its thing naturally if possible. You will probably have to slowly wean yourself off of laxatives now but I feel it would be a good idea to get a physicians opinion on this b/4 you procede. A urogyn should be able to guide you and I highly recommend you try to find one; you will be able to get checked for how your healing is progressing too. It is unfortunate that you have to consider shifting to a different dr but you need someone to answer your concerns.

For constipation, I use a few things (I have had constipation issues for a long time, IBS related as well as POP). I take 6 probiotic capsules a day (2 caps 3X day), you can find these at vitamin/health food stores. I have used Activia yogurt, that helps. I also find eating crushed pineapple helps quite a bit. Apple juice and apples are helpful as are most fruits but I think you are already doing fruit on a pretty large scale. Back off on the grain fiber, try to use just fruit for fiber, I feel it helps more in a situation like this. Keep up with the stool softeners though.

I was 55 when I had my surgery in 2008, I don't think age is the issue here-I think you simply should have been guided by your physician better than you were. I hear stories DAILY from women who have complications after POP surgeries done by physicians other than urogyns. It doesn't mean they are not good  physicians, the scenario is that POP sugery is extremely intricate, and the quality of the outcome is directly related to how well the procedure is done, the follow up after the procedure by the physician, and the patient taking steps to do all of the right stuff after the procedure. That being said, I had a 12 week heal curve-but then I also had a grade rectocele, enterocele, and cystocele procedure. I went to my urogyn with  a ton of questions and she took her time with  me and answered them all; the followup care I got was great too. By 6 weeks I was moving around pretty good, but still used the beanbag heat pad at night to help with discomfort and swelling.

Please try to stay hopeful, I do feel you will get past this, you just need to shift to a practioner who has the time/interest in truly caring for her patients, not just cutting and then walking away. If you decide you want to get checked by a urogyn and don't know how to find one in your area, give me a shout and I'll see what I can find out for you.

Sher
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