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Rectal pain during D

I had a D&C (for blighted ovum)POD 31. During the D&C I experienced excruciating rectal pain. F/U US showed no fluid. The intense rectal pain lasted ~30" after the procedure. Since this procedure I have had difficulty evacuating my bowels: 15" of straining with BM ~1' later. I've also had urinary retention- lack of sensation of need to void until bladder is overextended, then complete emptying requires repeated changes in body position while voiding. I have had no rectal pain since, but considerable RLQ pain and pelvic pressure.

F/U (POD 14) US revealed a ruptured ov cyst with hematoma ~3.8mm. WBC wnl. ESR 58. Big deal. These bowel and bladder symptoms have continued with no change. BM's are soft, formed- not constipation. Urine C&S wnl.

2nd GYN says that all of these symptoms are related to the cyst. This would mean that I ovulated at the exact moment that the D&C was completed. What???

What could have caused this rectal pain and continuing GI/GU symptoms? I've asked the GYN- who insists the only bowel injury could be a perforation. WBC wnl, afebrile. I'd be dead this far out if it was. I figured it was time to get the opinion of a GI doc regarding the anatomy and physiology questions surrounding these symptoms. (Perhaps the GYN blinders are on?) I'm frustrated.
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I'm not aware of the rectal pain being associated with the D&C procedure, unless some of the nerves innervating the rectal area were damaged during the D&C - but this would be less likely.

You can consider a referral to a GI doc or rectal surgeon.  In addition to a digital rectal exam, an endoscopy can be considered to look for any masses which may be causing your symptoms - especially in light of the difficulties in bowel movements.  If the pain continues, you may want to consider a rectal biopsy.

Tough to say without examination.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
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