After my 1st son i suffered a VERY painful 4th degree episiotomy. The cut was so bad that i couldn't get numb even after several shoots of what ever they use to numb ya with. I felt every insert of the needle and thread, Pull and Knot!!!! It was insane. Since then I've always knew something was wrong i couldn't hold my stool as i once did Pre-pregnancy. I never suffered incontinence (beside when i had diarrhea) BUT if i wasn't just seconds from a bath room i know i would have had a serious mess on my hands! I've done pretty well arranging my life around my B.M. Holding gas is also another problem!
Since I've had my last child i decided to make an appointment. with a colon rectal surgeon to fix the problem once and for all. I was told was i have a muscle gap in my rectum and that i would need Sphincteroplasty to repair that missing muscle by overlapping the muscles together.
I'm curious to know if a colon rectal surgeon would also be able to repair my perineum being that i have suffered from urine incontinence after sneezing, coughing, laughter you would surely hear me say the ALL to familiar ooo oh or opps! I would like to have the two done at the same time (Sphincteroplasty and Perineoplasty).
I'm not really sure if colon rectal surgeons do both surgeries?
And to have this done as an out patient is down right scary to me.
**Also i don't mind traveling to Ft Worth. for good Doctor that is takes enough time to explain his/her prognosis, How the operation will be preformed, his or her success rate and of course In-patient care!
Thank you, Kim, for starting a new thread! I tried and tried but gave up!
Rgold, I am so sorry you are dealing with these types of issues. I can't believe you could feel the dr. sewing you back up, that is horrible!!
I would search out another opinion for your surgery. I have never heard of a sphincteroplasty surgery done as outpatient; that would be impossible. I have read many of the boards regarding this surgery, and all of the girls were in the hospital for at least 4 days. I am almost certain that a colo-rectal surgeon would be able to do a perinealoplasty too, as I have read that many of the ladies had this procedure done at the same time as the sphincteroplasty. In fact, I think my surgeon did on one me since he said he "made more space between the vagina and rectum, and bulked up the area.". I can also tell things are different.
Kim, how are you doing? I think I overdid it this weekend. I was so excited for the nice weather that we were on the go the whole weekend. I bought a memory foam pillow like you have, and it helps a lot. I brought it to restaurants (embarassing, but oh well!) and rode in the car with it. Anyway, on our way home tonight I was saying to my husband how sore I was and how I needed to soak in a big tub of hot water. I took a look at the wound, and I was pretty surprised at how open it still is after 8 1/2 weeks. Pretty frustrating....
Sorry I have been out of commision. We went away for the long holiday weekend. It is good to be back and part of the conversation!
I had a perinealoplasty, sphincteroplasty and levatoroplasy done all by my colo-rectal Dr. I was also in the hospital for 5 days and off work for 9 weeks. I would not get the surgery done on an outpatient basis, but if I remember correctly some girls who just have the sphincterplasty done have had it done on a outpatient basis. I can't even imagine that. I needed more help in the hospital that there is no way I could have done at home. Keep researching and hopefully you will find what you need to help you.
I have decided to stop my fiber pills and try something else. I have been eating apples everyday so hopefully it will help. Who ever thought finding the perfect bm would be so hard!
Spring08 and Kim,
Listen to you bodies and don't let anybody tell you you are ready to do more things. Nobody really knows unless they have been through it. Enjoy your summer
Thank you for responding to my previous thread, and helping me to answer these questions (It can be a little busy with a 4 mos old!), as I appreciate it very much. I am scheduled for surgery for this Thursday for a sphincterplasty, and I am anticipating to be there for a few days. I am very nervous, but these threads have helped me to get more prepared on what to expect. I will check back in once I get home, and let everyone know how it went, wish me luck!
Good luck this Thursday, I will be thinking about you. Please let us know how you are doing once you are home and feeling up to it!
I wanted to ask you how long your stool leakage lasted. If I remember correctly, your surgery was last fall, right? I am having terrible stool leakage lately, and yesterday it even went into my underwear (it soaked through the gauze). I started crying, I was so frustrated! I called the dr's office today and talked to the nurse. She said if I still have an open wound (which I do), things are not healed all the way and the sphincter can only hold so much back. She said that the leakage is coming from the rectum - as opposed to the wound as Kim's dr. told her - and that I should try to keep my stools as firm as possible by taking Benefiber or something. I'm so confused!!!! Is it coming from the rectum or the wound??? From everything I have read, it seems that everyone experiences leakage after this surgery, and some women never regain control of gas. I was just curious as to your experience.
Thanks for any information you can provide!!!
I have been reading all your posts for quite some time. I was also told I needed a sphincteroplasty, but when he described what that was, I was petrified. I did lots of internet searching and RGold I had an absolutely wonderful Dr. in the Dallas area. He understood my hesitation and recommended I first try the Interstim implant. That was 3 years ago and I am like a new person, because of it. It is mainly used for bladder incontinence, but they found that it was helping with fecal incontinence also.
I since have moved from Texas. ( removed )
If not, I highly recommnend checking into this procedure first. They do a trial test, and at first you feel kind of like a car idling inside of you, but you really get used to it and hardly know its there. It is done as an outpatient, and is a minor procedure.
Last edited by moderator2; 05-27-2008 at 03:23 PM.
Reason: please read the rules yourself instead of asking members about them - your question is answered there.
I completely understand your frustration. Yes, I had my surgery last September, so I am about 8 months post, and I still from time to time have little leakage, but like I said before nothing like I had before. It does depend on the consistency of and how firm or loose it is, but I have not stained my undies or felt like I had stuff in my pants when I am out, which was horrible. Give it some time, however I know how frustrating it can be. If you still have an open wound and it is still draining, you are still healing. I do remember it felt like years before I completely felt normal. There is nothing worse than fearing you have gone through this surgery and felt like it didn't work. I think most women out there who have had the surgery will tell you they are glad they did it. If you have had loose stools lately then that might be why you were leaking? I would try the fiber and see what happens. I know how you feel though, I was petrified about constipation, but having milk of mag around made me not as nervous because I knew if I ever got in a bind, that would work to clean me out.
When was your surgery again? I hope this helps. Just remember, you are still healing and it might take a few months to even up to a year to get everything back in working order. They completely shut down my bowels in the hospital (5 days), so it kinda went to sleep and after I started eating and healing it was like it had to remember how to start working again. Make sense? Hang in there and ask me anything. I remember it helped me tremendously to have somebody to talk to.
Thank you for your nice post. My surgery was March 28th. It does make me feel better to have people to talk to who have been through or who are going through this surgery. It is no cakewalk, that is for sure! I have decided to take the rest of the school year off (only 2 weeks left of school, anyway). When I called the dr's office yesterday to request a note, the nurse goes, "Um, okaaaaaaaaaay. Why do you need this note again?" I explained to her that I teach little children, which requires a lot of moving, bending, squatting, etc., and that I didn't feel comfortable yet doing all of this with an open wound on my bottom. She didn't really understand and I hung up feeling like she thought I was "milking" the situation. I wanted to be like, "Have you ever had this surgery???" Ugh.
As for the leaking, I am going to try taking Benefiber more often to see what happens. I didn't have any leaking pre-surgery, that is why it is so frustrating for me. I had a rectovaginal fistula, which caused stool to leak out of the vagina, which is worse that it coming from the bottom, but still. They did a sphincteroplasty b/c they found my squeezing numbers to be really low, so they suggested to do the fistula and sphincter repair at the same time. I felt like my bowels were shut down, too, as they didn't have me eating for 5 days.
Thanks again for your support! Thank God for this board!
Went to the colon rectal surgeon yesterday and she suggested I take a fibber supplement if I'm not having fecal inconsistence excpet when i have soft stool. BUT the problem is even when my stool is well formed it sits VERY low to wear if I'm not by the bath room it would just come right on out and i don't even have to push when I'm @ the commode!!! So she goes well let me examin you. As soon as she did the digital exam she said: "Wow that went in there way to easy" lool. I was like uhhh yeah. The doctor said that the middle part of the sphincter muscle is missing and i have a very thin perennial wall.
She referred me to a urologist for the urine inconsistence and thin wall. I was then told that any surgery that needed to be done would be done at the same time and i would have to stay 2 days in the hospital (I'm gonna try to work them for a full 4 to 5 days.)
She also stated if i go with the sphincteroplasty it will never be 100% (of course) and that it would last about 10 years and depending on nerve damage it might not even work at all!!!
I asked if there were any test that could be done to find out if the nerves are working well enough to consider the surgery? She said that she'll order a pudendal nerve conductive velocity study (which i read is a bit painful )
Question about the interim implant:
Is it successful for people missing an anal sphincter or in my case part of an anal sphincter (it's just not there i guess its just skin and tissue) or for those who just have a weak sphincter?
Also wasn't the humming annoying? I don't think the implant is for me being that ummmm... Not to be gross and sorry if this is TMI but I'm afraid that i would be in a heightened erotic state. Being the humming is in/near a very sensitive area!
Hopefully the Nerve Study would come out well. I've been living like this for 10 yrs. I always wanted to fix this defect BUT I wonder if i should just leave well enough alone? is surgery gonna make it worse? maybe I'm just scared and getting Pre-surgery jitters i don't know .
And I'm off to the urologist today.
I have decided to take the rest of the school year off (only 2 weeks left of school, anyway). When I called the dr.'s office yesterday to request a note, the nurse goes, "Um, okaaaaaaaaaay. Why do you need this note again?" I explained to her that I teach little children, which requires a lot of moving, bending, squatting, etc., and that I didn't feel comfortable yet doing all of this with an open wound on my bottom. She didn't really understand and I hung up feeling like she thought I was "milking" the situation. I wanted to be like, "Have you ever had this surgery???" Ugh.
I Get sooo ****** when people have the nerve to tell you how you should heal and recuperate! i was in the hospital about 2wks ago. healing from a complicated tonsillectomy (according to the doctor) and, A bad morphine allergy reaction (went into full on anaphylactic shock) while i was in the recovery room they were telling me how well other patients were doing and how i should be drinking and sleep by now with all the pain meds. that they gave me! (which didn't help btw) I have a nasty lil' habit of sticking up for myself i responded with: "Don't tell me how other patients are doing I'm not them I'm in PAIN!" I'm not even sure it it was intelligible being that i could barely open my mouth and my throat was 4 times its normal size! They sent me home ended up in the ER stayed in the hospital for 5 days! As if people enjoy feeling like crap and hanging out in the hospital or tied their house for weeks! **end of rant**
I too had nerve damage and had the test. It was not painful at all, just uncomfortable, but not painful. Anyway, most of my nerves on both sides were gone, which means I don't have any push control. I too was told it might not work especially with the nerve damage. My ultrasound showed a tear almost half my sphincter. Having accidents and having anxiety of going out in public and and not being able to play with my kids was well worth the risk. I lived with it for a very long time and just thought this is life after kids, but after finding this board the the many women who have the same thing is very comforting. I had one Dr. at a very large, well known medical facility, in fact she was one of the best colo-rectal dr.s around told me I had to live with it and to use a cotton ball up my you know what!!!! I just about died. If you do not have this problem nobody understands what it can do to you. I would do the surgery again in a heartbeat. If I didn't do anything, it would have progressed with age and the weakening of muscles. If this can give me 10 more years of not crapping on myself I will take it. Everybody has to make their own decision and do what is best for them, but after having the surgery I have had no accidents or even felt like I was going to have one. It is a sense of relief.
Don't let them feel like you are using them! Like you said, nobody know a thing about this surgery unless they have been through it themselves. We on this board know you need the time and that is all that matters.
Poor me! I was sacked out all weekend after going back to work part-time (4-7 hours per day) last week. Thank goodness for the 3-day weekend. Then yesterday had a fever of 102. Wah-wah!
Sweet story. One of the things that I'll miss the most in the 6 months post-surgery is riding my bike with family around our neighborhood and city. The doc said it would be at least 6 months before I could ride my bike--maybe more. Sat was my 11th anniversary and my husband surprised me with a borrowed pedi-cab (like a big tricycle with a bench on the back for passengers. So the only time I left the house all weekend was riding to a restaurant on the ped-cab with my 3-yr old (My 8-yr old rode her own bike). So sweet! It was the best gift I've ever received.
Update. My stool leakage seems to be slightly improved. I still take a below-the-waist showers pretty much after each BM. I'm returning to being conscious about my fiber intake and drinking water. I don't do fiber supplements, but eat high-fiber cereal and colorful meals.
Rgold, I'll try and give my friend a call this evening to see if she can round up some colo-rectal recommendations for you in the DFW area. On an older post regarding the whole deal with fecal incontinence, someone described it like having a BM all day long, because you don't have the ring-like sphincter muscles to push a BM out, pinch it off, or pull it back in. So especially when BMs are pasty, it's just messy and never done. My doctor said that the sphincter muscles should be like a doughnut, but after the obstetric trauma it didn't heal right. So the muscles were more like a U. After the surgery, the doc told me that it was even worse than he expected (especially on the right side). he was surprised I wasnt in diapers. I already have more control than I did. I did all those "pelvic floor" exams. They weren't painful or anything.
Spring, I'm sorry that your wound is not healing as fast as you'd like. I'm so glad that you're taking more time off from work and able to have the summer as well. Rest up!
Update 2 Another long post.
Bottom (Haha) line:
I just got back from the urologist i was told i need a bladder sling and that should rule out the perioplasty because i don't have a perineum muscle to repair?! **** you learn something new everyday... But i remember a lady on this board who said she didn't have a perineum muscle either yet she was going in for a perioplasty.
So i thought that was a bit strange that she would say that. I'm sure they have muscle graphs mesh or even animal materials that they could use.
My Visit Story:
I swear today was a bit depressing being that 2 out of 3 doctors I've seen so far are a uncomfortable with preforming this surgery because according to them I'm too young to have this type of surgery!
She brought up my age about 15 times. And we had this 20min. back and forth thing about What if i get pregnant which wouldn't be a big deal. Any good doctor should ask about future pregnancies but to grill your patient for 20min about a none issue? she even told me i should have my tubes tied along with sphincterplasty, bladder sling, and if i can help it perioplasty talk about overdoing it!
I said NO way I know how NOT to get pregnant birth control & DH is all ready plaining to get fixed. The very reason why i didn't have surgery 10yrs ago after the birth of my first child was because i wasn't finished having children the BUT idea of sterilizing myself was out of the question! She even asked in a round about way if i would consider abortion if i were to get pregnant! Oh ****. I'm not too sure about this Doctor.
So i told her i was done with this issue again I'm NOT having anymore children, I know I'm "young", plus you usually do this type of surgery for 40+ (and you like to live in the land of "what ifs") I fully understand BUT can we deal with my medical condition here. URGH!
Oh she also thought i should go in for a Uro dynamics testing.
Doctors make things sooo complicated. I about 99.9% sure the "mis"-info on the whole perioplasty is off base
Again I'm lost. the first doctor (colon rectal surgeon) was more comfortable with doing the surgery, but i don't think he will attempt to repair the perineum i hope he will refer me to a doc who can. Hopefully i can kill two birds with one stone.
I just might go back to him. I'm trying find articles that deal with perioplasty for people with perineum muscle but i haven't been able to find one if you run across any new articles please post!!! TIA.
And Thank you ALL for your support. If i didn't have this board i don't know what i would do!
Missy, we'll be thinking about you tomorrow when you go in for surgery. Let us know how it goes when you get a chance.
rgold, I can't believe the doctors you've run across. I would continue the search.
Hang in there. I was going to let my original colo-rectal surgeon do the surgery even though I had my doubts about her confidence and experience. Turns out that a friend's husband (who's an anesthesiologist) recommended a couple of other docs.
Go with your instincts. If you don't have a good feeling about these folks, keep looking. The doctor who did my surgery says that he performs them often on women of "child-bearing" age. He didn't judge my age or birth control methods, etc. Also, I don't think thst the perinium has anything to do with the bladder. Isn't it the space between the vulva and the anus. When I asked my doctor if he would be doing perinial repair, he said that the sphincteroplasty necesitates some perinial repair due to the location and nature of the surgery. Turns out that he did quite a bit of aesthetic work down there. Before surgery, my labia did not come together anymore at the perinium (almost like my vaginal opening was trenched open toward the bottom, b/c it obviously didn't heal right. So the doc fixed it so that it looks more like pre-birth status. Anyway, my doc only identified me for a sphincteroplasty although he did more down there. Each doctor is definitely unique, right?
wishing everyone health,
Last edited by moderator2; 05-28-2008 at 07:48 PM.
After you have the implant, you really do not notice the humming/vibration. When I first had the test, I thought I would never get used to it. After a couple of hours it was already diminshed. It can be set to go on and off. You also have a control to lesser the strength of the pulses. It is located in a certain area which you thought might be too sensitive. Trust me, it is not like that. The wires are implanted and then they can adjust the sensations to where it is most helpful. I really cannot say enough good things about it. I lived for over 16 years with muscle weakness, and this has helped tremendously.
It can be used for damaged sphincter muscles, I am living proof of that. It is just an alternative, it might not be the right answer for you, but it sure is easier than many of the stories we hear about. If the surgeon doesn't think you would be a candidate for it, he wouldn't implant one.
As I said earlier it is mainly used for bladder incontinence, and a urologist is more familiar with it.
Good luck, this is not something we deserve to have happen to us.
Well according to her i don't have much bladder support which i guess was due from having multiple children. Ive seen a urologist and took a uro dynamics test about 6yr ago and i was fine. So the bladder support issue may be a whole new thing. I thought the urinary incontinence was due to the fact of the 4th degree episiotomy that left me without a perineum muscle and sphincter muscle. Hopefully the test will show that everything is fine as far as my bladder and urethra.
I think a lot of doctors are leery of women coming in for a "perioplasty". But when a woman walks in like me they should know what the deal is. Hello i don't have a muscle its a defect and i shouldn't have to live with this issue nor talk my way into this surgery.
I will also try to get a hold of the 1st colon rectal surgeon and see if he is willing to repair that area. Hopefully the wouldn't view it as i just want a tighter snatch lol blah.
Clancey- I will def. ask the surgeon about the implant. My problem is i don't have any muscle for it to work with just skin and tissue. so he'll prob. say that's a no go.
Last edited by rgold; 05-28-2008 at 09:06 PM.
Reason: please do not ask members to post against the rules
Any reputable colorectal surgeon should be able to do a perinealplasty. It is basically part of the surgery. I didn't have any muscle there either, and the purpose of that surgery is to take other muscles and tissue, and build up and bulk up the area of the perineum. I also know someone who had her surgery coordinated with a urologist at the same time and had a bladder sling done at the same time as the sphincteroplasty, perinealplasty, and rectocel repair. I would keep searching. You absolutely need a GOOD surgeon. Don't be afraid to ask them how many of these procedures they have done. You need to feel comfortable with your decision. My ob/gyn was going to do my surgery, but I felt more comfortable with the colorectal surgeon after talking with him. I was 34 when I had it done. Also, more children is still possible, but a c-section would be advised. Take care,
I had outpatient sphincteroplasty 8 days ago for bowel incontinence. I didn't ask the doctor enough questions, and I assumed the recovery would be easy because it was outpatient. I was even on a conference call for work at 9am the following day - ridiculous. I have learned a lot about being my own advocate with the medical profession in the last week.
My problem was the result of a 3rd degree tear following the birth of my second son (8 lbs 12 oz, and I'm a small woman). I could make it to the bathroom unless I had diarrhea. The doctor did a colonoscopy the day before my surgery, so you can imagine what the prep was like. I would be standing in the bathroom and not be able to make it to the toilet. Disgusting!
My doctor told me not to do any heavy lifting for 10 days after my surgery. I asked him about my 22 pound 8 month old, and he said I could lift him. So, I carried him around despite the pain. I have a low tolerance for pain, but I was surprised that I was still on pain medicine 3 days after surgery. Then, 5 days after surgery, my stitches must have pulled loose. I had sharp pains that felt like knives sticking me. I had almost weaned myself off the pain medicine, and this hurt worse than it had the whole time. I called the doctor who said my stitches were probably separating and that they wouldn't go back in and sew me up because of risk of infection. I just wish I'd taken it easier. Until I found your posts, I thought I was a wimp and that I should just ignore the pain and go on with my life. I'm just hoping all of this is worth it in the long run.
In the last thread, several of you mentioned silver nitrate. What is that for? I'm wondering if I'll have to have that because my wound opened up. This time, I want to be prepared when I go back to the doctor.
Thanks so much to all of you for sharing your experiences. It helps tremendously to know there are others out there going through this.
I second that on finding an experienced colo-rectal dr. I would not have had the surgery without one. Ask lots of questions. It seems like every Dr. is different when it comes to this surgery. I too had the perinealoplasty along with my sphincterplasty and the colo-rectal Dr. did all of it.
I have stopped taking my metamucil pills for fiber and was wondering if you can think of anything else I can take for fiber. My problem is I am not a very good eater (never have been) when it comes to veggies and fruits which is why I think I have always had a problem with being regular. I do drink coffee in the morning, but it doesn't help me. I have been trying to be a better eater and eating more fruit. I have been eating a apple a day, but was wondering if you know of anything fiber wise that seems to work pretty good. I am not sure the pills were for me. Any suggestions you can give me would be great.
clancey, I appreciate you discussing an alternative to the sphincteroplasty. The more information the better!
Suzanne, so glad you found us so you realize that you are NOT a wimp at all! You definitely need to take it easy and try to recup as much as you can. Is there any way you can get more help as to avoid standing, sitting, and being active for long? For example, avoid picking up you sweet li'l baby and have folks hand him to you. As you can see from the posts, most of us are aghast when we hear about this operation as out-patient (I was in the hospital for 5 days). YIKES! Many of us had doctors who told us 2 weeks to recup or longer. For example my doc said 2 weeks and I'd be back at work most likely. I didn't go back until 3 weeks PART-TIME and it was TOUGH. And when I'm home, I'm side-lying--not lifting a finger to do a thing. I'm now 4 and a half weeks post-op and still shuffling around, grunting, groaning after a 4-6 hour work day, & taking showers after many of my BMs. I think we all agree that it takes longer than what the medical community seems to let on.
My doc said that most his patients end up popping those external sutures which results in an open wound about the size of a dime or quarter. They pop because the skin is so delicate down there and the pelvic floor holds the entire weight of our upper body and is often used for our everyday movements. He, like your doctor, said they wouldn't suture it up again for fear of infection and the likelihood of them popping again. Best advice: keep area as clean and dry as you can (my doc recommends placing a hair dryer on the COOL setting after shower or peri-bottle rinse) & place some gauze between your cheeks to catch the discharge from wound. My wound never got bigger than a coupl of peas (knock on wood) so I never inquired about the silver nitrate, but previous posts discuss the pros and cons a little bit.
Take care everyone!
Last edited by kim71; 05-29-2008 at 11:54 AM.
Reason: more info added