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Old 03-16-2011, 06:19 PM   #1
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Cross Over Sphincteroplasty - very frightened

I need to talk to women who have had this procedure. The surgeon wants to schedule me for it. After reading about it, I'm very frightened. How do I find out if this surgeon is good? How do I find out if his patients felt the surgery was a "success"? I have horrible gas incontinence with the beginnings of trouble getting to the bathroom in time for bowel movements.
I really need to get some feedback and info on this.
Thank you.

 
Old 03-16-2011, 10:19 PM   #2
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Re: Cross Over Sphincteroplasty - very frightened

I am so sorry for the problems you are experiencing. I don't know much about this surgery, but I know it's to try and reverse the incontinence. Also, I'm not sure what you mean by "cross over." My only question is what kind of surgeon is he? Is he a colorectal surgeon? That's the kind of surgeon I would recommend. Someone who specializes in it. You don't want just any surgeon doing it. 7 weeks ago, I had a hemorrhoidectomy done by a colorectal surgeon. He did an excellent job. He was recommended to me by my gastroenterologist. Maybe you could call your primary care physician or your gastro's office and ask if they have heard anything about this doctor. I've heard of people on this board using general surgeons to perform their surgeries and it hasn't turned out so good for them. Also, do you feel comfortable with this doctor? Just make sure you're being operated on (in that area) by a colorectal surgeon. I hope this helps you a little. Good luck with everything. Hugs!

 
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Old 03-17-2011, 03:54 AM   #3
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Re: Cross Over Sphincteroplasty - very frightened

This is probably an overlapping sphincteroplasty you're talking about. I have a few questions for you:
How long ago did you have your 4th degree tear?
How long did it take for the gas incontinence to start and then the fecal incontinence?
Have you had an ultrasound done of the muscles and what was the outcome?
Have you done kegels/physiotherapy to strengthen the muscles?

 
Old 03-19-2011, 08:20 PM   #4
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Re: Cross Over Sphincteroplasty - very frightened

I had my first baby and the 4th degree tear 31 years ago. I started having gas incontinence about 8 years ago. I started having trouble making it to the bathroom in time for solid stool about 3 years ago, and I have "accidents" with liquid stool. The gas incontinence is terrible! I make lots of noise although no smell. I have very weak pelvic floor muscles. I am not comfortable with the surgeon/colo-rectal Dr. He gave me no info on what to expect with this surgery. He did a digital exam and said that I had a very thin wall between my rectum and my vagina, and lots of damage from childbirth. I have been very stressed reading all of the posts from patients who have had this surgery. Their post surgical stories sound awful. I'm not sure what to do. I can't be away from work for months on end to heal! I can't afford it. I have to work. However, work is a nightmare because of the noisy gas. I don't always make it to the bathroom in time to mask the fact that I have gas.

 
Old 03-20-2011, 05:49 AM   #5
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Re: Cross Over Sphincteroplasty - very frightened

Since your problems came so many years after your birth (my problems came immediately afterwards), this would indicate that you have some sort of muscle that has kept you continent for many years. My first advice is to do Kegel exercises, for 3-6 months, to see if there is an improvement before you do any surgery.

Women with a 3rd or 4th degree tear should do kegels everyday for the rest of our lives, starting straight after birth. You should have been told to do the exercises 31 years ago, and never stop.

It takes a long time for the effect of kegels to show, but I have hopes for you since you only started getting symptoms 20 years after your birth, this would indicate some sort of muscle that has been able to hold it in earlier. If they help, you have to continue doing them until you are old and senile and don't know what a kegel is anymore

If the kegels don't help after 3-6 months, then you should consider surgery.

 
Old 03-20-2011, 04:33 PM   #6
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Re: Cross Over Sphincteroplasty - very frightened

Babygirl43, thank you for your reply. I have spent hours reading the posts on this surgery. I find it very depressing. I am on the verge of tears often because of the stress of my situation. Now I find that so many others have the same situation and that we never get back to being 100%. This dashes a lot of hope for me. My surgeon recommended the surgery after only a brief manual exam of my bum. No one ever told me to do Kegels after I gave birth. No one ever told me that the 4th degree would cause any problems. No one has told me anything! Via email, I found a PT who specializes in the pelvic floor, and she has called me on the phone and tried to tell me how to do Kegels. I still don't get it. I think I must have a very, very weak pelvic floor. I have no control over gas and it is noisy 90% of the time. Work is such a nightmare. I have a BM several times a day, and no one told me that wasn't 'normal'. Before childbirth, I went about once per day and felt "finished". Now, I often, sometimes constantly feel that I have to use the bathroom. For several years after I gave birth, I think I was doing pretty well. However, as I have read all of these posts, I realize that I have been having problems for a long time. I have been having "peeking out" if I don't get to the bathroom in time. Pre-childbearing I could hold off a BM indefinitely. Pre-childbearing I never had gas issues. Now it is so bad that I can't stay at church, can't socialize, can't have visitors in my home, and am afraid to travel due to the noisy gas. I have radically changed my diet. Nothing. I am so afraid that this can't be helped and this is the main reason the Dr. actually suggested the surgery! Now I read that so many who have the surgery never conquer the gas control. I read of how some have gone back to work and yet still have to 'clean up' after a BM. This is impossible where I work. There is no way I could work and heal as I've read about. I am so terribly afraid and worried about all of this. How do I find a pelvic floor specialty clinic? I have some pretty basic questions to ask. First of all, what is a "normal" BM? What is a "normal" consistency? I don't think I know anymore. Second, please describe the Kegel exercise for me. I was briefly told once to do them for a bladder problem, but then we had to move to a small city and there was no Dr. here who specializes in Pelvic Floor issues so I got out of the habit. The PT on the phone described it, but I'm not sure I'm doing it correctly. It just feels so useless and weak. Very stressed. The weekend is over and I go back to work tomorrow. I haven't eaten all day to see if that will help. So worried. How are you recovering? How long ago was your surgery?

 
Old 03-21-2011, 04:44 AM   #7
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Re: Cross Over Sphincteroplasty - very frightened

Hi. My surgery was almost 5 months ago and I'm doping pretty well. I have no post-BM clean-up issues. I still have urgency sometimes, but by far not as often as before surgery (then it would be at every BM). I can sometimes feel the urge, ignore it and finish doing what I was doing. This was impossible before surgery. I also am now slowly starting to get control over gas, after 4 months of daily kegels. My gas doesn't make any noise anyway, usually! It sounds like you have had issues since birth, but you haven't realized that it was because of the tear? It might well be wise to do the surgery. I was very scared because of all the stories on this board, but this surgery was pretty successful for me. It will take a while for things to stabalize and I'm still having issues like several BMs a day on a bad day. But usually 1-2, which I can live with.

About kegels, it's difficult to explain, other than you should squeeze so your vagina and rectum close and lift slightly, like you're stopping your urine.

I advise you to have an ultrasound scan done of your rectal muscles to see the extent of the damage. I can't help you with your work-related issues, I don't know what work you do. But I guess sometimes your health is the most important, no matter what work you have.

 
Old 03-27-2011, 11:26 AM   #8
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Re: Cross Over Sphincteroplasty - very frightened

Eljay,
I know exactly how you feel and what you are going through. Ask your surgeon if you are a candidate for an Interstim implant. Look it up and read about it. If he doesn't do them find a surgeon who does. I had one implanted about 6 years ago and it has been wonderful. It has improved the quality of my life tremendously.
Clancey

 
Old 04-02-2011, 02:36 PM   #9
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Re: Cross Over Sphincteroplasty - very frightened

I"m scheduled for May 9th in Chicago, and am scared. As it seems most colorectal surgeons seem to have the same bad bedside manner, mine has yet to go over everything with me. My story is i am 50, and last year just started with fecal incontinence, supposedly my pelvic floor muscles compensated for the torn Sphincter. I am scheduled for an external anal sphincteroplasty (my tear is between 10 and 2 if you picture a clock) and peritenal reconstruction and a TVT sling. Three surgeons, and 5 hours I'm told it will be (by the urogynecologist as she seems to be the nicest and most supportive of the bunch), and 5 days minimum in hospital.

Please, if you have a similar situation, can you share with me what to expect? I read about fistulas and I want to bail. I read on older threads from a few years ago you have an open wound at the rectum post surgery but I'm not sure if i can compare to those women as they had just given birth. My last child was 12 years ago.

If someone can share their surgical experience, post op of what to expect and how long life is not normal, can you return to normal life and drink alcohol, have fun, dance, etc within a decent amount of time?? I've managed my issues with Imodium when it gets bad, but i'm not incontinent daily as i must have a strong pelvic floor. The tear is real, and large so you'd think i'd be suffering daily but i'm not. But, that could happen later in life when I'm too old to consider surgery.

Any and all input would be appreciated!!!!

 
Old 04-03-2011, 02:46 AM   #10
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Re: Cross Over Sphincteroplasty - very frightened

My advice is, after you are done with your surgery, do kegels for the rest of your life. Especially since you only started having problems at age 50, I would think there are great possibilities for you to get back to normal. Kegels are very important in the recuperation after this surgery.

Because you're having several different procedures done, you should take it easy for at least 6 weeks I would think. Things get slowly better, and after a month you will feel a big improvement healing wise, but things take time. Sphincter function can take a year to improve with kegel exercises. But the wound should in theory be closed by 6 weeks, although some women experience a wound that take 6 months to close. Most women don't get fistulas after this surgery, although I agree the prospect is scary. Make sure they don't cut into your internal sphincter if it is intact, as internal sphincter defect is one of the reasons why many of us don't get a 100% improvement.

Good luck!

 
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Old 04-03-2011, 03:34 AM   #11
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Re: Cross Over Sphincteroplasty - very frightened

Quote:
Originally Posted by Babygirl43 View Post
My advice is, after you are done with your surgery, do kegels for the rest of your life. Especially since you only started having problems at age 50, I would think there are great possibilities for you to get back to normal. Kegels are very important in the recuperation after this surgery.

Because you're having several different procedures done, you should take it easy for at least 6 weeks I would think. Things get slowly better, and after a month you will feel a big improvement healing wise, but things take time. Sphincter function can take a year to improve with kegel exercises. But the wound should in theory be closed by 6 weeks, although some women experience a wound that take 6 months to close. Most women don't get fistulas after this surgery, although I agree the prospect is scary. Make sure they don't cut into your internal sphincter if it is intact, as internal sphincter defect is one of the reasons why many of us don't get a 100% improvement.

Good luck!
Thanks so much for your help, I really appreciate it.

 
Old 09-01-2011, 05:12 AM   #12
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Re: Cross Over Sphincteroplasty - very frightened

Quote:
Originally Posted by eljay1 View Post
I need to talk to women who have had this procedure. The surgeon wants to schedule me for it. After reading about it, I'm very frightened. How do I find out if this surgeon is good? How do I find out if his patients felt the surgery was a "success"? I have horrible gas incontinence with the beginnings of trouble getting to the bathroom in time for bowel movements.
I really need to get some feedback and info on this.
Thank you.
Did you get your information? I had this surgery in May, am willing to share my experience. I did fine, no problems, and healed nicely, minimal pain.

 
Old 10-21-2011, 02:19 PM   #13
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RE: Sphincteroplasty - questions about recovery

I am a bit over two weeks into recovery of a sphincteroplasty, perineum repair and recto-vaginal fistula repair. I started having gas and liquid stool incontinence through my vagina, due to the fistula, so was not aware that my rectum was also damaged from a 4th degree episiotomy. The damage from childbirth was 12 years ago.

I was elated once the fistula was repaired because gas actually came out of where it was supposed to. The rectal area and fistula appear to be healing appropriately but I have a rather large opening/sore in the perineum. I have been back to the doctor twice, there is no secondary infection, but it hasn't improved over the last five days. I use the hand held shower head many times throughout the day and wake up at night when I feel uncomfortable from the drainage and clean the area and air dry it out.

Has anyone experienced this? Any advise? I am allergic to Neosporin, or at least one of the antibiotics in it, so haven't used that. I am testing bacitracin on a wound on my leg to see if I'm allergic and will try to use that upon Dr. recommendation. I am just worried the perineum wound will continue to open and affect the rectum inside.

 
Old 10-21-2011, 06:03 PM   #14
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Re: Sphincteroplasty - questions about recovery

What you describe doesn't sound that unusual to me based on what I've read on these boards, but I can understand how stressful it is. When my first repair didn't work due to infection, I did a few things differently when I had a second surgery. My doctor was able to set up a visiting nurse who came by to check the wound every couple of days. This gave me tremendous reassurance. I also upped my protein (protein shakes daily) and took arnica, which is a homeopathic remedy that one of my OBs mentioned I could try. Both protein and arnica help expedite healing. Just a few ideas to help you support the work your body is doing right now!

 
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Old 10-29-2011, 01:29 PM   #15
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Re: Cross Over Sphincteroplasty - very frightened

I had the same procedures in April 2011. Your situation sounds like many of ours. While it is scary, i dont think that you have a reason to be alarmed yet. Especially if there is no sign of infection. Feel better soon.

Blessings,
Amomma

 
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