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rectocele/intussusception

I am wondering if you can help me sort this out.  I had a TVH , and later a cystocele and rectocele repair.  That was 2 years ago.  I am having pelvic pressure and pain, especially rectally.  I had a defecogram done, and it said rectocele with internal intussusception.  I was sent to a colon and rectal surgeon.  He said resection and rectopexy.  I went to two other colon and rectal surgeons, and they reviewed the film and did not see hardly any intussusception.  So I went to the uro gyn that did my rectocele repair.  He seems to think I need my vagina pulled up, sacral colpopexy. And then repair the rectocele vaginally.  My question is will this pull up my rectum as well?  Can this fix the intussusception?  I really want this to be my last surgery.  Can the uro gyn pull up the rectum as well?  I do have incomplete evacuation after having a bowel movement.  I am seeing a physical therapist too, at the request of one of the colon and rectal surgeons.  I mean I feel like my intestines are falling out. Any advice?  thank you for listening.

suzanne
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242593 tn?1313864321
MEDICAL PROFESSIONAL
This sounds like you have prolapse of the top of the vagina, as well as some descent of the rectum ( At least according to the opinion of one colorectal surgeon). The good news is that if you get the abdominal sacralcolpopexy, then you can also have the rectopexy done at the same time, it involves putting in an extra couple of stitches to pull up the rectum, fixing the intersusseption. This combined procedure should fix the rectal and vaginal prolapse. I find that most of my patients who have an abdominal sacralcolpopexy do not need to have a rectocele repair at the time of the sacralcolpopexy.

Please verify that you  are going to a fellowship trained urogynecologist, who has done many of this type of procedure

Dr. Hoyte
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Avatar universal
A related discussion, Crohns and rectocele was started.
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242593 tn?1313864321
MEDICAL PROFESSIONAL
Hi again,

During the abdominal sacralcolpopexy, the rectopexy can also be performed, which usually helps fix the rectal intersussecption. In my patients, this tends to help those with defecation problems associated with vaginal and/or rectal prolapse.

Dr. hoyte
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Avatar universal
prolapsed,

Are they giving you a resection, with the rectopexy?  Or are they just pulling your intenines up?  I am having surgery on WED.  scared.
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Avatar universal
hi yes i agree with you but the reason they didnt do mine ? they said it was too much surgery all at once apparently when you have an hystrectomy this operation can interfere with bowels so in my case  they wanted every thing to settle down before next op but do agree with you 1oo%
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Avatar universal
I talked to my uro gyn.  He said that he can pull up my rectum as well when he does the sacral colpopexy.  He said to do the rescetion as the last resort.  I am scheducled for the 25th of June for the surgery.  I am scared.  I just want this to solve my problem.  Since this will be another abdominal scar, I am having a plastic surgeon do a tummy tuck at the end, hope that it is not too much.
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Avatar universal
b24
Why do they do all these other surgeries if a hysterectomy will cure all problems?  I do not understand some of the approaches or thinking at all.  If the uterus pulls down it creats discomfort.  The organs are joined by ligaments, nerves, blood vessels and do not float in space or separate of each other.  To pull down on all above creates a force and so on that affects all organs.  Why do they not seem to know this?  It explains many complaints of pain and discomfort that women make all of the time.  It makes perfect logic and sense but still it does not seem to compute with some.  Am I alone in this in stating that they do not always listen or attend to what the woman says?
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Avatar universal
im the exact same as you  can go in the morning but after that no chance i think rectopexy needs a colorectal surgeon  because its bowel side of things my gyno said im going to give you hystrectomy ? but will leave bowel side  he said he wasnt expert in this field ? its very complexed  i felt i was going round in circles good luck when ive had my surgery i promise i will keep you all posted asap  good luck  xxxxx
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Avatar universal
Dr Hoyte?

Can the uro gyn do the rectopexy for me?  The colo rectal doc  at the same hospital is one of the docs that does not see the intussusception.  I am havng stool that is stuck, and sometimes pretty bad rectal vaginal pain, spasms.

Thank you
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Avatar universal
Let me know how your surgery comes out, because my lining they told me was very lose and that the next surgery is to tack my lining to my back. The rectopexy surgery was about 5 hours and it wasn't that bad. The lay up time was the worse.
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Avatar universal
How did they diagnois this?  The operation the uro gyn wants to do is sacral colopoexy which is only pulling up the vagina.  He did not mention rectpexy, but a colo rectal surgeon did.  Will they be doing a resection of the bowel too?  I can have a bowel movement in the morning, but then not completely and then this freeling like something is stuck up there .  What kind of doctor is doing this?  thanks for your reply.
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Avatar universal
hi im suffering the same as you i think im trying to get as much information as possible  i used to feel as though my insides were falling out  i think this is because of periniel decent forgive spelling ? ive had rectocele repair last oct 4 months after hystrectomy  in jan 08 now waiting for surgery again  for internal mucosa prolapse i think its lining of bowel  they are going to go in through my abdomen to lift  the op is called anteria rectopexy maybe this is what your going to have i can totally undestand you ? this is my 4th op in as many months im totally gutted but got severe constipation and feel  as though i cant take this no more   i go in hospital any time now  the doc says this needs putting back up surgically  because nothing else will help  thanks for your  input  good luck from prolapsed
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