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Old 04-22-2010, 05:36 PM   #1
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Sphincteroplasty after 4th degree tear

Hi, I have been reading some of the posts on sphincteroplasty, I am scheduled to have this procedure done at the end of next month. However, now I am considering moving it to a later date. I am still nursing my 9 month old she will be 10 months at the time of surgery. If I have the surgery will I be able to care for her and lift her? Maybe I should wait until she can walk?
I suffered a 4th degree tear at my delivery 9 months ago, it was a vacuum assisted delivery and the ob cut a midline episiotomy. I started having bowel incontinence immediately. I couldn't hold on to any stool it was awful. My ob kept saying I had good muscle tone and nothing was wrong, everything would heal in time. After 6 months I was still having accidents about 2 week. I then went to a colorectal surgeon who found I have defects in both the external and internal sphincters. The internal sphincter is actually torn and is not a complete circle and my external has gaps in the muscle tissue where the episiotomy tore through.
I have read some of the posts where people had unsuccessful surgeries, this really scares me. I would be so upset if this got worse.
I am really interested to hear if I will be able to care for my baby. We really don't have any family close by. So I will have to plan very carefully if this is the case. I am so happy I found this board, because I felt I was the only one with this problem (at least that is what my ob said).
would love to hear your opinions

 
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Old 04-22-2010, 08:33 PM   #2
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Re: Sphincteroplasty after 4th degree tear

Hi! I had sphinteroplasty surgery about 5 wks ago. I have a 5 1/2 month old & had to have either my Mom or husband home w/me for the first 2 weeks to care for her. Then I started to hold her more & more after that but trust me, you don't want to do anything that could make the surgery unsuccessful. Good Luck!

 
Old 04-23-2010, 04:19 AM   #3
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Re: Sphincteroplasty after 4th degree tear

Thanks for your reply! I will probably hold off on the surgery for a couple of months until I have stopped nursing. I will also try and arrange for someone to come and stay with us to help care for the baby.

 
Old 04-23-2010, 06:57 AM   #4
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Re: Sphincteroplasty after 4th degree tear

Your OB sounds like a piece of work! Glad you're getting some help. I had a 4th degree tear as well, 13 years ago. NO fun.

Did your doctor discuss the risks of future pregnancies, deliveries with you?

 
Old 04-24-2010, 01:41 PM   #5
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Re: Sphincteroplasty after 4th degree tear

Hi everyone! I just had my surgery 4/8. Everything has seemed to go OK. My "baby" is almost 16 years old! Didn't think this would ever happen as a result, but he is worth it. Personally, if you can manage with your current problems for a while, I would wait until you stop breastfeeding. Since my surgery I have lost about 5 pounds in 2 weeks. I discovered that I did a lot of between meal snacking prior to my surgery. The paranoia of having an accident while out has caused me to only eat when I can do my post op enema regimen (3x per day). You don't want to be losing weight while breastfeeding. Also, the high iron content of the prenatal vitamins (which breastfeeding moms should be on) won't be allowed post op.

 
Old 04-25-2010, 05:34 AM   #6
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Re: Sphincteroplasty after 4th degree tear

Thank you for your reply. I hope you will get better soon from your surgery. I will probably hold off on my surgery until I stop nursing. I have already lost a lot of weight due to the nursing and I really do not need to compound this problem. I also realize I need to arrange for someone to come and stay if I have the surgery. Again thank you so much everyone for your replies it makes me feel I am not alone in this!

 
Old 04-25-2010, 06:31 AM   #7
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Re: Sphincteroplasty after 4th degree tear

Oh, you're not alone! And I'm jealous that you're getting to address your issue. I've not yet actively begun (I have a LOT of pelvic floor issues) but plan to this fall.

Keep us posted!

 
Old 04-25-2010, 08:14 AM   #8
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Re: Sphincteroplasty after 4th degree tear

I think that is a good decision. We will be here for you when you decide to have surgery.

 
Old 04-25-2010, 10:56 PM   #9
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Re: Sphincteroplasty after 4th degree tear

You are definately not alone in this. Although, I agree that it feels like you are alone because it is a very sensitive issue that you don't tell just anybody about. I felt like I was the only person in the world going through fecal incontinence and when I found this message board, it made me feel so much better to know that many others were in the same situation as me. I am 3 weeks post-op, so it is hard to say how much improvement I will have but I am hoping to be back to new!! Recovery has not been too bad for me, but my children are 18 and 15, so I haven't had to take care of anybody. I would want someone to help take care of the baby if I were you. Good luck and I hope all goes well for you!

 
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Old 04-26-2010, 05:42 PM   #10
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Re: Sphincteroplasty after 4th degree tear

A good friend told me one time "the truth shall set you free". I try to remember that when there is something that I don't want to talk about. Actually, if you are real open and educate the public, they are very supportive. I just tell people that I need the area of my old episiotomy/tear fixed. I read 30% of women who have a tear wind up needing sphincteroplasty eventually. They don't ask much more. Anyone who has I go ahead and tell. It really is easier than trying to hide everything. I won't lok back on my decision. I'm glad I did it and hopefully there will be an improvement for me.

 
Old 09-15-2010, 03:20 AM   #11
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Re: Sphincteroplasty after 4th degree tear

Lillypetnunia, just wondering if you've had your surgery? And if so, how did it go?

VP1963, how are you doing? Have you noticed any improvements since you last posted? Did you have many accidents after surgery? I don't know if I read that correctly. I'm so worried about getting worse rather than better after surgery....

 
Old 09-15-2010, 12:10 PM   #12
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Re: Sphincteroplasty after 4th degree tear

Another question regarding the sphincteroplasty:
I have read that several women have had problems with audible gas after surgery. I had this for a month after birth, but now it's no longer audible (although not stoppable either!). I feel I will be embarrassed to go back to work after a month with uncontrollable audible gas. Please share experiences with me regarding this, it would be greatly appreciated!

 
Old 09-18-2010, 09:16 PM   #13
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Re: Sphincteroplasty after 4th degree tear

Sorry for the late reply. Things are basically the same as they have been. Life is fine if my stool has a good consistency, but when it is like "toothpaste" I have to wipe a lot. I am just lazy about getting enough fiber in my diet sometimes. Whether things are downhill since surgery or just the same is a good question. I am not sure anything is really different, it may just be that doing the enemas after surgery covered up any issues. I don't tend to go to the bathroom a lot, and I have found that if it has been too long, I am better off with the enema in the pm and having everything out in 15 minutes. It isn't truly an "accident" per se in that nothing comes through to the underwear, just some left over to wipe if the stool consistency is like toothpaste. I don't regret my surgery at all, and from what I have read a high percentage of patients are not "perfect" afterward. I wouldn't necessarily go into having surgery with that expectation. Would I do it again? I don't think that I would ever bother with repeat surgery unless I had a situation where I couldn't hold things in. It is just to easy to "clean yourself out" at night and then not have a thing to worry about vs go through another procedure for me.

 
Old 09-19-2010, 12:00 AM   #14
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Re: Sphincteroplasty after 4th degree tear

Thanks for your reply! I was just wondering if you had the wiping issue before surgery or did it come after surgery? And have you noticed that the muscles are stronger after surgery? Thanks!

 
Old 09-19-2010, 07:20 AM   #15
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Re: Sphincteroplasty after 4th degree tear

I finally had my surgery! I had it on September 10 so I am still healing (9 days post op). It has felt like i can hold things in better but I am not sure yet. I am taking stool softeners so it is hard to hold in liquid stool anyways. I am a bit concerned though because all of a sudden I noticed a hole in the middle of the perineum. I have also had some bleeding and pus drainage. I called the hospital yesterday (of course it has to be the weekend when something happens) and the physician I talked to did not sound concerned. This morning I noticed yet another hole. It looks really gross and scary. The holes are closer to the vaginal opening than the rectum so I just hope I won't break apart lower down. I suspect the holes just create a way for the infection to drain out but I am still scared. After all I have been through I don't think I could take another repair. I am on two different antibiotics so i am just hoping the infection will go away. I will call my surgeon tomorrow. I'll keep you guys posted on my progress.

 
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4th degree tear, bowel incontinence, sphincteroplasty



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