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Old 12-06-2010, 07:25 AM   #46
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Re: Sphincteroplasty after 4th degree tear

wow, babygirl you are so lucky, I am so glad your wound has already healed! I am now 3 months out from my surgery and my wound still hasn't healed up, I just had the last few stitches removed this morning. I hope it is going to heal now, I think the stitches actually made it more difficult for the wound to heal properly. But I am sure they were left in there for so long for some reason. I had a terrible infection post-surgery so this has made the recovery longer. The good news is that I have very good control and it keeps improving with time. These are the differences I notice post-surgery:

only go to the bathroom twice a day, before I would go about 5-7 times.
no leaking issues
better control of gas (although not 100% yet)
control of liquid stool (before I had no control of liquid stool)
no more urinary urgency, this was completely gone immediately post-surgery, some nerves must have been crossed or something don't know why I had this problem but it is completely gone, somehow having the surgery completely cured this.

Some negative things I have noticed is that my perineum is very thin and there is not much space between the vaginal opening and the anus. But I am hoping this will change as my wound heal further. I still have about half an inch opening in the perineum but hoping this will close now when the last stitches have been removed.

good luck with your recovery

 
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Old 12-07-2010, 11:31 AM   #47
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Re: Sphincteroplasty after 4th degree tear

Hi Lilypetunia. I'm sorry to hear you still have problems with the wound. I'm glad that my wound has healed yes, but I feel you're luckier than I am with your results. I still have a way to go there, as I still have urgency of solid stool (although less so than before), can't hold in liquid stool, and have to go to the bathroom 4 times a day, rather than 2 times (pre-surgery). My goal is once a day (like pre-birth), but I don't know if this will ever happen. I also find it difficult to evacuate everything, as the passage is narrower, which is probably the reason why I have to go so often. So, once your wound has healed, it sounds like you will have such great results! I hope I'm as lucky as you with time Did you notice your results immediately after surgery or have things improved over the past months? I hope your wound will soon be better.

 
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Old 12-08-2010, 10:27 AM   #48
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Re: Sphincteroplasty after 4th degree tear

I felt a difference immediately after surgery, however I have gradually improved over the past 3 months. I had little control of gas in the beginning and now have some control of it but not like pre-childbirth. Also, I had a lot of urgency problems in the beginning but that has also improved a lot. I do still have urgency when I need to go and I still run to the bathroom because I am so used to doing that. But no accidents so far.
I haven't done kegels yet because I have been worried about the wound but I am hoping that when my wound heals I can further improve with physical therapy. I believe it takes about a year to reach "full results" from the surgery. So I am sure you will improve more with time, best of luck!

 
Old 12-20-2010, 02:18 PM   #49
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Re: Sphincteroplasty after 4th degree tear

I'm glad you have seen gradual improvement these past 3 months. I know what you mean about the rushing to the bathroom out of habit!

Did you notice any increased mucus production? This is my main problem at the moment as it's hard to control and I can't always feel it coming out. It sort of leaks out when I feel the urge to go, which is very annoying. Luckily it's not always present, but I never had this problem before. My other problem is having to go to the bathroom more often than I'd like (4 times a day). How are these issues for you (mucus and BM frequency)?

 
Old 12-27-2010, 04:38 PM   #50
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Re: Sphincteroplasty after 4th degree tear

Hi lilypetunia, I just located this board today and found your threads. I would like to know if your surgery has helped with your bowel incontinence. I suffer also with this devastating problem. I would love to hear from you. Thanks, hollysmom

 
Old 12-28-2010, 10:25 AM   #51
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Re: Sphincteroplasty after 4th degree tear

Me too...I am just trying to find SOMEONE who has had good results from their repairs. I am faced with the decision to 'TRY AGAIN' or just have a colostomy done. My last repair was in Aug and failed...then I had to have my gallbladder removed in Oct. which they said was causing my 'Explosive diarrhea'...although I am much worse with the diarrhea now than ever before. Since August I have had two urinary tract infections and I KNOW that is because of having accidents where I cannot get cleaned up right away ie; while driving my daughter to school in the morning and having to 'sit in it' until I can get home. My surgeon ran all the 'tests/ultrasound' again and found that the repair had failed internally and externally and told me we could try again in March 2011 because if we tried now it would be like he was dealing with 'hamburger' and I need the full 6 months to heal. I have news for him...my perineum is so hard I don't think he will be able to even get back in there....not sure if I will even ever be able to use my vagina again. I know the opening is much smaller and hardened then the last time it was 'used'.
I was not going to post any more on this site so to not discourage anyone from seeking HELP with this arduous infliction but I realize that all should be told and 'inform-able' decisions made in having this done. I have not found 'long term' good news for this type of repair. I am 48 years old...divorced because of it...have a 13 year old to raise and feel like my quality of life is over. I am afraid to go out of my house...even in diapers because they LEAK and cause urinary tract infections...I can't go visit my family who live in the state but I cant take the chance of driving long periods or FLYING for that matter...God forbid I would have an accident in those situations...it is so bad I have to have a shower. Right now I am trying to find out if I will be 'employable' with a colostomy...my insurance runs out soon and I will need a JOB in order to get insurance. As it stands right now I am uninsurable and do not qualify for 'assistance' in any way...

 
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Old 12-28-2010, 10:28 AM   #52
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Re: Sphincteroplasty after 4th degree tear

Lilly...I too took a long time for my wound to heal...now it is very hard with scar tissue. Please make sure that you 'message' the tissue on your perineum etc. so you don't develop horrendous scar tissue as I have.

 
Old 12-28-2010, 06:08 PM   #53
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Re: Sphincteroplasty after 4th degree tear

flsunshine, Hi it's me again, hollysmom, I think I got 2 posts from you. Not really sure how all this works, but I want to make sure you get my replies. My heart aches for you as well as the others. I really thought I was the only person in the world with this problem. It does help to know that I am not alone. To be honest with you, I don't know if having a 6th surgery is really worth it. I mean, how much cutting and stitching can those sphincter muscles take before they become completely atrophied. Have you gotten a second, third, or should I say 6th opinion? I am going to give the next 3-4 months alot of work with Kegels, but then is no results, I will need to take this further. I will be doing alot of research in the mean time. I understand your despair, but for your daughters sake, hang in there. I did read a post from a younger woman who was dreading a colostomy (due to a disease, not obstetrical tear) and she had no choice, but she has had it for awhile and did say that it isn't as bad as she had expected, and she now has her life back. It would be nice not to be afraid to leave the house and to be able to do things with our children again. Everytime I am out and have a accident, I know it breaks my kids hearts. Sometimes, I think my daughter thinks it is her fault, so I try to reassure her that it has nothing to do with her birth, although it does, its not her fault... I put the blame on the doctor! Let me know how you are... hang in there, we will get this fixed somehow! Hugs to you. hollysmom

 
Old 12-29-2010, 06:55 AM   #54
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Re: Sphincteroplasty after 4th degree tear

I am so sorry flsunshine, my heart goes out to you. I am surprised they have put you through so many repairs, from what my surgeon told me it seemed like they can only do this type of surgery once? There is another treatment on the horizon and according to my surgeon it will be approved for bowel incontinence in the next few years. It is called sacral nerve stimulation, currently it is only approved for urinary incontinence, but apparently works for bowel incontinence also. Maybe worth it to discuss with your surgeon. Best of luck to you. I hope everything works out. Hugs
Hollysmom, I am really happy to say that I have very good control and it seems to keep improving, for the past 2 weeks I have been back to only 1 bm per day, I have not gone only once per day since before giving birth. Before the surgery I went 5-7 times per day (throughout day). Immediately after surgery I went 2-3 times per day (all in the am). The only change I have made in the past 2 weeks is taking a probiotic, I don't know if this what has improved me or not or if it is just that I am healing more and more. But I am definitely sticking with the probiotic. I also seem to completely evacuate everything whereas before I had to wipe and wipe. I also have no leakage etc. The only thing that I don't have complete control of is gas, but I have been told that is nearly impossible. From what my surgeon says only 1% of patients have perfect results and I guess for most the repair only lasts for 10 years, so I am hoping that by then there are alternate treatments available.
All in all I feel that my surgery was successful, I still have a big hole in my perineum (from what is left of it) about 3/4 inch wide and 1/4 inch deep, don't know if it will ever heal up as I have seen no change in the past 2 weeks. I am seeing my surgeon next week so I will see what she says.
On another note, did any of you consider suing the ob that did this to you? From what I have been told this should not happen in this day and age. I got my tear because of a botched vacuum delivery, I was told by the ob that my baby was stuck and in distress and they had to get her out quickly. I ordered the delivery notes after and in them it states they used vacuum delivery because I was exhausted and ASKED for a vacuum delivery. This is a complete LIE, I did not want a vacuum delivery.....
Also, my ob handled everything really badly afterwards, when I was complaining of incontinence, one of her comments was maybe because I drink coffee in the morning that is what makes me have accidents. Grrr, I have to stop writing now because it just makes me too mad to think about this. Good luck everyone!

 
Old 12-29-2010, 09:39 AM   #55
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Re: Sphincteroplasty after 4th degree tear

First of all thank you for 'being there'...as you know this is so hard to talk about let alone have anyone understand that hasn't gone through this. Yes, I have consulted many surgeons about this. My surgeon retested the nerves and all that with the ultrasound tests they do and said I would benefit from another surgery. I started crying and that is when he said I could have an artificial sphincter or a permanent colostomy. In other words...you do have other 'choices'. Just the thought of enduring another surgery crumbles me. No, I can't give up...for my daughter's sake...her father is a jerk and HE is his only priority in life.
I too was told my daughter was in distress and we had to get her out....I can't sue because it was a military hospital. Although, would have a case especially since it was a vaginal birth after c-section...they should have just scheduled me for the c-section especially since my water broke 42 hours before being induced. I have made sure that the reason for my colon problems are not 'voiced' in front of my daughter. I imagine she thinks that it was caused by my cervical/uterine cancer. Because when I had the hysterectomy is when the 'major repair' was done in conjunction with a bladder suspension and vaginal reconstruction from the fistula. Mind you right after my daughter was born they 'repaired' it then also and I ended up with a fistula after that. (I split so much that they had to put a catheter in my urethra to sew me up 'that way'.
I have a question for you all. When you had your s-plasty done did you stay in the hospital at all? I was sent home (an hour and a half drive) right away. Not that I am saying that is the reason for the failure. I did everything exactly as was told to do plus. I believe that my recurrent diarrheal cause the failure because of all the inflammation it causes. As a matter of fact, the surgeon discussed having at least a temporary colostomy done with the next re-repair.
Wow, when you READ 'your story' it seems so monumental...more so than as you live it. No wonder my husband of 25 years left me huh? I have to say that there are times that I want to scream at him and say 'Yeah, you enjoy being a father AND having a life with your 'air matresses'....he left me for a flight attendant. I call her his 'air mattress'.
As for how long it takes for the 'wound' to heal...mine took three months. As time goes by it heals a little slower because of the tissue granulation. That is why I said to make sure you message the perineum religiously so to try not to form a hardened scar. Keep in mind how many times I have endured this surgery when you hear how scared/hard mine is...you have to keep it 'pliable'...my surgeon suggested swimming even when the wound was 'open' but I got so sick from the gallbladder removal that I did not continue. Now when I go to sit on the toilet it hurts because of the pulling of the tissues. I guess that is why they say the 'sitz baths' are so important to continue so you are relaxing the tissue and keeping it pliable? I remember the doctor and nurse telling me that 'water' was going to become my best friend. LOL I can say this...if I decide to try one more time I will be a little more prepared than I was this past time. I will have a 'shower chair' with an open bottom for my shower to use with the handheld shower. Picking up/dealing with the sitz bath tub was not a good thing to be lifting etc but I believe you need the slight stretching of the tissues down there with 'water therapy' to keep things from getting too tight. I could not imagine trying to get in and out of a 'tub' early on in recovery...especially since they told me NO SQUATTING...Just 'my' thoughts...I am not a doctor.
Ok I have to close here and get some laundry 'completed'. SmiLe Thanks again you all for 'being there'. (((((Hugs)))))

 
Old 12-29-2010, 09:47 AM   #56
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Re: Sphincteroplasty after 4th degree tear

Quote:
Originally Posted by lilypetunia View Post
I am so sorry flsunshine, my heart goes out to you. I am surprised they have put you through so many repairs, from what my surgeon told me it seemed like they can only do this type of surgery once? There is another treatment on the horizon and according to my surgeon it will be approved for bowel incontinence in the next few years. It is called sacral nerve stimulation, currently it is only approved for urinary incontinence, but apparently works for bowel incontinence also. Maybe worth it to discuss with your surgeon. Best of luck to you. I hope everything works out. Hugs
Hollysmom, I am really happy to say that I have very good control and it seems to keep improving, for the past 2 weeks I have been back to only 1 bm per day, I have not gone only once per day since before giving birth. Before the surgery I went 5-7 times per day (throughout day). Immediately after surgery I went 2-3 times per day (all in the am). The only change I have made in the past 2 weeks is taking a probiotic, I don't know if this what has improved me or not or if it is just that I am healing more and more. But I am definitely sticking with the probiotic. I also seem to completely evacuate everything whereas before I had to wipe and wipe. I also have no leakage etc. The only thing that I don't have complete control of is gas, but I have been told that is nearly impossible. From what my surgeon says only 1% of patients have perfect results and I guess for most the repair only lasts for 10 years, so I am hoping that by then there are alternate treatments available.
All in all I feel that my surgery was successful, I still have a big hole in my perineum (from what is left of it) about 3/4 inch wide and 1/4 inch deep, don't know if it will ever heal up as I have seen no change in the past 2 weeks. I am seeing my surgeon next week so I will see what she says.
On another note, did any of you consider suing the ob that did this to you? From what I have been told this should not happen in this day and age. I got my tear because of a botched vacuum delivery, I was told by the ob that my baby was stuck and in distress and they had to get her out quickly. I ordered the delivery notes after and in them it states they used vacuum delivery because I was exhausted and ASKED for a vacuum delivery. This is a complete LIE, I did not want a vacuum delivery.....
Also, my ob handled everything really badly afterwards, when I was complaining of incontinence, one of her comments was maybe because I drink coffee in the morning that is what makes me have accidents. Grrr, I have to stop writing now because it just makes me too mad to think about this. Good luck everyone!
Ooops almost forgot...Lillypetunia, I heard that the sacral nerve stimulation will only work if the muscles are intact. Although, I have not done a LOT of research on it as of yet.

 
Old 12-29-2010, 12:00 PM   #57
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Re: Sphincteroplasty after 4th degree tear

Quote:
Originally Posted by lilypetunia View Post
I am so sorry flsunshine, my heart goes out to you. I am surprised they have put you through so many repairs, from what my surgeon told me it seemed like they can only do this type of surgery once? There is another treatment on the horizon and according to my surgeon it will be approved for bowel incontinence in the next few years. It is called sacral nerve stimulation, currently it is only approved for urinary incontinence, but apparently works for bowel incontinence also. Maybe worth it to discuss with your surgeon. Best of luck to you. I hope everything works out. Hugs
Hollysmom, I am really happy to say that I have very good control and it seems to keep improving, for the past 2 weeks I have been back to only 1 bm per day, I have not gone only once per day since before giving birth. Before the surgery I went 5-7 times per day (throughout day). Immediately after surgery I went 2-3 times per day (all in the am). The only change I have made in the past 2 weeks is taking a probiotic, I don't know if this what has improved me or not or if it is just that I am healing more and more. But I am definitely sticking with the probiotic. I also seem to completely evacuate everything whereas before I had to wipe and wipe. I also have no leakage etc. The only thing that I don't have complete control of is gas, but I have been told that is nearly impossible. From what my surgeon says only 1% of patients have perfect results and I guess for most the repair only lasts for 10 years, so I am hoping that by then there are alternate treatments available.
All in all I feel that my surgery was successful, I still have a big hole in my perineum (from what is left of it) about 3/4 inch wide and 1/4 inch deep, don't know if it will ever heal up as I have seen no change in the past 2 weeks. I am seeing my surgeon next week so I will see what she says.
On another note, did any of you consider suing the ob that did this to you? From what I have been told this should not happen in this day and age. I got my tear because of a botched vacuum delivery, I was told by the ob that my baby was stuck and in distress and they had to get her out quickly. I ordered the delivery notes after and in them it states they used vacuum delivery because I was exhausted and ASKED for a vacuum delivery. This is a complete LIE, I did not want a vacuum delivery.....
Also, my ob handled everything really badly afterwards, when I was complaining of incontinence, one of her comments was maybe because I drink coffee in the morning that is what makes me have accidents. Grrr, I have to stop writing now because it just makes me too mad to think about this. Good luck everyone!
Hi Lilypetunia,
Glad to hear the good news on your recovery. My delivery was just like yours with the use of a vacuum. The doctor who delivered me was in a big rush for no reason. My delivery only took 1 hour and 15 minutes total for my first baby. This is why my sphincters are torn now. It really makes me mad as well and I try to focus on my beautiful baby. I did consult with a lawyer and they looked into my delivery. Unfortunately, they consider this a complication of a vaginal delivery. It is really hard to prove that the physician caused this due to rushing the baby out or not taking the time to properly repair the sphincters. I think the ob should be responsible for this injury and maybe this would never happen anymore. Why does the s-plasty only lasts for 10 years? Does the muscle come unattached or is it a nerve problem. I have heard a lot of good news about the sacral nerve stimulation. I am so afraid to have the s-plasty done. After hearing your good results and also from Babygirl, it gives me hope. Thanks for sharing!

 
Old 12-29-2010, 01:12 PM   #58
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Re: Sphincteroplasty after 4th degree tear

I just want to mention this 10 year thing some of you are holding onto. Some research has found that 5-10 years after a s-plasty, the results start worsening. This is mainly due to muscle weakening, some say also due to nerve damage. This research however mentions nothing about if the women have done biofeedback/kegels after surgery or not. You have to do these for the rest of your life and the surgery has a much higher success rate. I read about one hospital with high success rates, and they had very good after-care with biofeedback training etc. I also read somewhere on this board that a surgeon had a patient who had the surgery done 30 years ago, and is still going strong. I don't know if she has done kegels, but still 30 years! So 10 years is only a statistic in a handful of research done on this topic, it doesn't mean that all surgeries will only last for 10 years. Since reseach has found that the result decreases with time, we HAVE to continue to do kegel exercises for the rest of our lives for this surgery to hold. So all you ladies, 3-5 minutes a day!!

Sacral nerve stimulation is good if there is nerve damage, but the sphincters still need to be intact, or at least partly.

I was very discouraged by all the posts here before surgery, and I'm very happy that my results are as good as they are.

 
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Old 12-29-2010, 02:11 PM   #59
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Re: Sphincteroplasty after 4th degree tear

Babygirl I am happy for you and YOU give me hope! Truly. I took my daughter to piano lessons today and on the way there I sneezed and you know what happened. I ended up not being able to go in with my daughter and waiting in the car...I made my decision right then...I am going to try again!

 
Old 12-30-2010, 06:24 AM   #60
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Re: Sphincteroplasty after 4th degree tear

flsunshine, I really think you should consider getting a 2nd opinion with another surgeon before doing another repair. Is your surgeon a colorectal surgeon? From what I have heard a lot of the success depends on the skill of the surgeon. I would only recommend a highly skilled colorectal specialist for this type of surgery. I know that some urogynocologists also do these surgeries but it really is not their specialty. I know you have been through a lot, you really deserve the best possible care. Also, your ex sounds like a piece of work, good riddance!
Thanks to those mentioning the physical therapy, I will definitely start the therapy again so that I can further strengthen my muscles. I feel that I am not really fully using my muscles down there because I have had a wound there for so long and I have been afraid doing kegels because of it.
Finally, when I feel down over what has happened to me, I just look at my beautiful healthy baby girl and I feel so lucky that it is just me and not her.

 
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