Any experience with rectocele? No one EVER talks about this!

Posted by flind @flind, Mar 7 10:42am

My situation: Self-diagnosed rectocele. Have appointment in 4 days to hopefully confirm or R/O. After 20 years on anti-depressants my constipation was so bad that I developed a rectocele. I hope to find out soon how large it is and how to treat it… Have been doing Kegels. Have had no other pelvic issues of any kind – ever (lucky, I know). Am post-menopausal, age 62. After ~4 months I successfully tapered off Venlafaxine down to zero (was NOT easy and that Mayo group was VERY helpful to me). One of the first things I noticed in tapering/ending AD's was being able to poop again! Hallelujah! But 20 years of constipation had taken its toll. Caution The Following is not for the faint of heart/squeamish (but this is a topic no one is talking about and I KNOW I can't be "the only one"…): I am getting too old for the physical contortionism necessary to extract poop from my rectum, not to mention sick of it. I go for annual gyno exam EVERY YEAR. Every visit I have complained about severe constipation. Lately I have even described how difficult it is to completely eliminate and having to use my fingers to get the poop out. Why has NO ONE ever said "rectocele"????? It took me several hours of sleuthing online to even find a word for it. And when I did it seemed like a fairly common physical ailment for women – and yet – there is very little out there about this condition. Most of the sites that mention rectocele do so 'in passing' while discussing pelvic prolapses. I in no way mean to belittle THAT horrible state of affairs… it's just not my personal issue and I want to know more about my personal issue. But everytime I try to find more info I end up reading stories about OTHER pelvic issues because if rectocele is mentioned at all it is in conjunction with these others. Please… has anyone else had this as their main or single issue who would be willing to share diagnosis, procedures, outcomes, what to expect/avoid? If so I would be truly grateful!

Hi, @flind Welcome to Connect. I see you have been here for a few weeks but this is the first time I have come across you.

I discovered when I went to the doctor for urinary incontinence that I have a rectocele too. I do have a problem sometimes with fecal incontinence but I don’t think the rectocele is actually causing that or other problems. The urogynecologist told me there is a surgery for rectoceles but she didn’t seem to recommend it. She did recommend a doctor at a different hospital that has been successful at correcting fecal incontinence but I have not pursued that. Is the rectocele causing any fecal incontinence? I was having a lot of diarrhea so it was a problem but when I finally figured out that I have become lactose intolerant and stopped eating goods containing lactose that problem went away for the most part. If there is fecal incontinence involved an extension of the regular kegels can help with that. You squeeze those muscled along with the usual muscles.

What kind of doctor are you seeing, and what does ”R/O” mean?
JK

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@contentandwell

Hi, @flind Welcome to Connect. I see you have been here for a few weeks but this is the first time I have come across you.

I discovered when I went to the doctor for urinary incontinence that I have a rectocele too. I do have a problem sometimes with fecal incontinence but I don’t think the rectocele is actually causing that or other problems. The urogynecologist told me there is a surgery for rectoceles but she didn’t seem to recommend it. She did recommend a doctor at a different hospital that has been successful at correcting fecal incontinence but I have not pursued that. Is the rectocele causing any fecal incontinence? I was having a lot of diarrhea so it was a problem but when I finally figured out that I have become lactose intolerant and stopped eating goods containing lactose that problem went away for the most part. If there is fecal incontinence involved an extension of the regular kegels can help with that. You squeeze those muscled along with the usual muscles.

What kind of doctor are you seeing, and what does ”R/O” mean?
JK

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Thank you JK. I appreciate your response. R/O – rule out the possibility of a rectocele. I am interested in "incomplete elimination" due to feces being literally TRAPPED in a rectocele. I'm not needing info re symptoms per se. I would like to know how the condition "rectocele" may have been (or failed to have been) addressed. Fecal incontinance (and many other symptoms) may well be associated with the condition but these are not of interest to me at this time as I have no extenuating factors – just a poop pouch I want to get rid of. I've no doubt a rectocele left untreated eventually leads to all manner of unpleasant symptoms. Which is my point! Why doctors, gynos especially, don't talk about it! The burdon is on patients to bring up a frankly embarrasing topic. Gynos have no problem proactively bringing up prolapses, atrophic vaginitis, urinary incontinence, even vaginismus… all of which get talked about a LOT, regularly and openly. But I sought relief from severe constipation for 20 years and was NEVER taken seriously – the result – a rectocele. I'm really not interested in comparing symptoms.I hope those who wish to discuss associated symptomology will start a NEW thread. I am only interested in the diagnosis & treatment of a rectocele. Has anyone had procedures to correct this as a single surgery. If so what kinds of outcomes were experienced. Do they have advice as far as what to expect/avoid in terms of surgery or other treatment for this one specific condition? I understand the norm is to consider the female urogenital tract/pelvic floor as a "lump" sum. In many cases this makes sense, but there is a dearth of information re individual components of the female pelvic region other than the vagina which (rightly enough) is paid plenty of attention. Thanks for your understanding…

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@flind

Thank you JK. I appreciate your response. R/O – rule out the possibility of a rectocele. I am interested in "incomplete elimination" due to feces being literally TRAPPED in a rectocele. I'm not needing info re symptoms per se. I would like to know how the condition "rectocele" may have been (or failed to have been) addressed. Fecal incontinance (and many other symptoms) may well be associated with the condition but these are not of interest to me at this time as I have no extenuating factors – just a poop pouch I want to get rid of. I've no doubt a rectocele left untreated eventually leads to all manner of unpleasant symptoms. Which is my point! Why doctors, gynos especially, don't talk about it! The burdon is on patients to bring up a frankly embarrasing topic. Gynos have no problem proactively bringing up prolapses, atrophic vaginitis, urinary incontinence, even vaginismus… all of which get talked about a LOT, regularly and openly. But I sought relief from severe constipation for 20 years and was NEVER taken seriously – the result – a rectocele. I'm really not interested in comparing symptoms.I hope those who wish to discuss associated symptomology will start a NEW thread. I am only interested in the diagnosis & treatment of a rectocele. Has anyone had procedures to correct this as a single surgery. If so what kinds of outcomes were experienced. Do they have advice as far as what to expect/avoid in terms of surgery or other treatment for this one specific condition? I understand the norm is to consider the female urogenital tract/pelvic floor as a "lump" sum. In many cases this makes sense, but there is a dearth of information re individual components of the female pelvic region other than the vagina which (rightly enough) is paid plenty of attention. Thanks for your understanding…

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@flind when I went to a physical therapist for urinary incontinence she suggested that the rectocele could be causing what I felt was fecal incontinence and told me about putting a sterile glove on and pushing it out manually.

This does seem to be a problem that doctors are loathe to bring up. I hope your appointment goes well and presents some solution. I hope too that you will post about it. I am very interested.
JK

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@contentandwell

@flind when I went to a physical therapist for urinary incontinence she suggested that the rectocele could be causing what I felt was fecal incontinence and told me about putting a sterile glove on and pushing it out manually.

This does seem to be a problem that doctors are loathe to bring up. I hope your appointment goes well and presents some solution. I hope too that you will post about it. I am very interested.
JK

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Thanks JK. You got it! This is exactly what I'm talking about. I do not think I can spend the rest of my life manually pushing poop out my patootie! I'm just not gonna be able to sustain this! I may be developing arthritis related to arm contortions… I will def post after my appt. Ty very much for your caring and interest!

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I had this condition, @flind, and I had surgery for it along with a repair for bladder prolapse about 8 years ago. I had no idea I even had it till it was pointed out to me. So, I would be another combination surgery situation. However, I can say that I do remember specifically having pain after the surgery right in that area, and that it did not feel too good. I was given painkillers, though, which helped make it at least tolerable. The other thing I remember is that having a first BM after surgery felt absolutely traumatic, like I was going to just pop my stitches right out. Scary, in a way. I was prescribed stool softeners, and finally I just had to go for it and try it out. It did hurt, then caused soreness for some time after my surgery (maybe 2 weeks?), but finally got better.

I did try a pessary before surgery (for all the fallen parts), but I was not a big fan. I know some women who use them for many years and are fine with it, however.

The difficulty is that now I know what a rectocele is, I think mine may be back again.

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@lisalucier

I had this condition, @flind, and I had surgery for it along with a repair for bladder prolapse about 8 years ago. I had no idea I even had it till it was pointed out to me. So, I would be another combination surgery situation. However, I can say that I do remember specifically having pain after the surgery right in that area, and that it did not feel too good. I was given painkillers, though, which helped make it at least tolerable. The other thing I remember is that having a first BM after surgery felt absolutely traumatic, like I was going to just pop my stitches right out. Scary, in a way. I was prescribed stool softeners, and finally I just had to go for it and try it out. It did hurt, then caused soreness for some time after my surgery (maybe 2 weeks?), but finally got better.

I did try a pessary before surgery (for all the fallen parts), but I was not a big fan. I know some women who use them for many years and are fine with it, however.

The difficulty is that now I know what a rectocele is, I think mine may be back again.

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@lisalucier @flind During the birth of my son I ripped right through my anal sphincter which is what they suggested may have caused my problem, even though it was many years later. I had pain similar to you, Lisa, when I had BMs. It was terrible, and every time I had one it of course made the problem worse. It took three months for me to heal. I could not ride comfortably in the car as a passenger so I would lay down in the back seat. Interestingly I could drive, maybe because I could anticipate the shifts in the car better and prepare for them.
JK

Liked by Lisa Lucier

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@contentandwell

@lisalucier @flind During the birth of my son I ripped right through my anal sphincter which is what they suggested may have caused my problem, even though it was many years later. I had pain similar to you, Lisa, when I had BMs. It was terrible, and every time I had one it of course made the problem worse. It took three months for me to heal. I could not ride comfortably in the car as a passenger so I would lay down in the back seat. Interestingly I could drive, maybe because I could anticipate the shifts in the car better and prepare for them.
JK

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You are a real hero

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@flind
I had surgery for bladder prolapse a couple of years ago. I was also told that I had a bit of a rectocele and it was repaired along with my bladder prolapse. I did not know about the retrocele until I went to the urogynecologist that did my surgery and when he got to deciding on the precise procedure he told me he was going to repair the retrocele as well. During this time I talked to a few female friends and one of my friends told me that she had a rectocele several years prior and that it was repaired. Hers was due to having had 3 rather large babies. She has not had any problems since the repair and I think it has been at least 20 years ago. I found that if you really want to have a conversation with a doctor about any of these issues, seeing a urogynecologist is best. A regular gynecologist just doesn't really know enough about the procedures in order to speak to you in the level of detail that you will want in order for you to get the information that will allow you to make decisions that are best for you.

A couple of things that you might expect is that the surgery that is suggested may be with the DaVinci robot which allows for faster healing and makes the surgery less invasive. I don't know for certain, but it is likely that hysterectomy will be a part of the surgery. Why? Only because of logistical reasons if the uterus is "in the way" of the area where the repair needs to take place. If your doctor wants to use mesh for the repair do not be immediately turned off to it. The mesh they use today is not the same mesh they used that caused all the lawsuits you may have seen on TV, It is a totally different material and is used when your doctor believes that simply repairing the tissue by stitching it up will not hold for the long term. My doctor used the newer mesh and I have not had any problems. I was hesitant at first but once I realized that my tissue was not going to hold without it and that I would likely end up having to go through the surgery again, I decided the mesh was the best procedure for my case.

I also understand from talking with people who have had rectocele repair that sometimes urologists and/or colorectal surgeons may be involved as well as urogynecological specialists. I do recall my surgeon who was a urogynecologist asking me if I had any problems with fecal elimination or any fecal incontinence. I did not have either but really did not know I had a rectocele until I went in to talk about surgery for my bladder prolapse.

Any procedure you will have will be done as an inpatient procedure and you will be in the hospital for at least one night. I live alone and requested to stay an additional night so I was there two nights. My advice is to stay as long as you possibly can because you will probably have a catheter and having your first BM after the surgery may or may not be painful or uncomfortable. But either way it is an important milestone for your recovery and you may want help available until you have it.

I wish you the best of luck. Do not be embarrassed at all. While it is not a conversation that is easy to have, I have found that it is increasingly common and if you get to the right specialist they will be able to discuss it with you thoroughly. What is more, they should have the ability to do so in a way that puts you at ease and invites your questions.

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@bill54321

You are a real hero

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Thanks @bill54321 but not really. The substitute doctor I had was just an idiot – my doctor was on vacation. Due to mistakes made in the birth of another child he was sued for a fortune and I believe he lost his license.
JK

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@baxtersmom

@flind
I had surgery for bladder prolapse a couple of years ago. I was also told that I had a bit of a rectocele and it was repaired along with my bladder prolapse. I did not know about the retrocele until I went to the urogynecologist that did my surgery and when he got to deciding on the precise procedure he told me he was going to repair the retrocele as well. During this time I talked to a few female friends and one of my friends told me that she had a rectocele several years prior and that it was repaired. Hers was due to having had 3 rather large babies. She has not had any problems since the repair and I think it has been at least 20 years ago. I found that if you really want to have a conversation with a doctor about any of these issues, seeing a urogynecologist is best. A regular gynecologist just doesn't really know enough about the procedures in order to speak to you in the level of detail that you will want in order for you to get the information that will allow you to make decisions that are best for you.

A couple of things that you might expect is that the surgery that is suggested may be with the DaVinci robot which allows for faster healing and makes the surgery less invasive. I don't know for certain, but it is likely that hysterectomy will be a part of the surgery. Why? Only because of logistical reasons if the uterus is "in the way" of the area where the repair needs to take place. If your doctor wants to use mesh for the repair do not be immediately turned off to it. The mesh they use today is not the same mesh they used that caused all the lawsuits you may have seen on TV, It is a totally different material and is used when your doctor believes that simply repairing the tissue by stitching it up will not hold for the long term. My doctor used the newer mesh and I have not had any problems. I was hesitant at first but once I realized that my tissue was not going to hold without it and that I would likely end up having to go through the surgery again, I decided the mesh was the best procedure for my case.

I also understand from talking with people who have had rectocele repair that sometimes urologists and/or colorectal surgeons may be involved as well as urogynecological specialists. I do recall my surgeon who was a urogynecologist asking me if I had any problems with fecal elimination or any fecal incontinence. I did not have either but really did not know I had a rectocele until I went in to talk about surgery for my bladder prolapse.

Any procedure you will have will be done as an inpatient procedure and you will be in the hospital for at least one night. I live alone and requested to stay an additional night so I was there two nights. My advice is to stay as long as you possibly can because you will probably have a catheter and having your first BM after the surgery may or may not be painful or uncomfortable. But either way it is an important milestone for your recovery and you may want help available until you have it.

I wish you the best of luck. Do not be embarrassed at all. While it is not a conversation that is easy to have, I have found that it is increasingly common and if you get to the right specialist they will be able to discuss it with you thoroughly. What is more, they should have the ability to do so in a way that puts you at ease and invites your questions.

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@flind I agree wholeheartedly with @baxtersmom that your best bet is a urogynecologist. My regular gynecologist actually referred me to a urologist rather than take incontinence on himself, but I chose to go with a urogynecologist. Since there is only one here in NH and she was booked quite a way out I went to one in MA who is on the staff at Mass General. I also had large babies — 9 pounds 2 ounces and 9 pounds 4 ounces, so that may have been the cause for me also.
Your issue is more complex than urinary complex so I would definitely go to a urogynecologist, but I wonder if this is something that proctologists treat also. I never pursued that route.
JK

Liked by Lisa Lucier, flind

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i"m here! have the same thing. and do the same thing to evacuate my bowels… with the fingers…. I get to the point that if is doesn't come out when I"m on the toilet,, I get frustrated and just get up and leave.. figure it will eventually come out. My bad back is making it difficult to use the finger technique at times… so,,,, I just get off the toilet and wait till later. I visited Mayo and the Dr told me to increase my orange fiber drink to 2x a day and with more spoonfuls in each glass. ( and lots of water). This has helped when I remember to stay consistent with it. He did say that he would do the surgery IF this did not work. HE also said NOT to use the fiber pills as the amount of fiber actually in them is not enough. ( I did not know this). Look at the label and see for yourself. it has to be the kind you mix with water. ( more fiber). I am 56,, and never had kids. I also had a bladder sling put in about 8 years ago for incontinence issues. I was told this has nothing to do with my poop problem. ( FYI). Your not alone!

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@mcmurf2 Welcome to connect as I have been reading all the post on rectocele The symptoms sound like I might have this also joy joy . Think I,ll talk with the Dr when my apt. I have been on the fiber pills but will switch to the liquid .

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@lioness

@mcmurf2 Welcome to connect as I have been reading all the post on rectocele The symptoms sound like I might have this also joy joy . Think I,ll talk with the Dr when my apt. I have been on the fiber pills but will switch to the liquid .

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Yes,, I had NO IDEA there was such a difference between the pills and the liquid… I think you will see a noted change when you switch.

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Thanks for all of your responses! I saw a NP at my GP's office. I didn't want a urogyno eval (as my condition is rectal) so the NP referred me to a colorectal specialist (surgeon) for evaluation. My appointment is still a week away. Will lyk…

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@mcmurf2

i"m here! have the same thing. and do the same thing to evacuate my bowels… with the fingers…. I get to the point that if is doesn't come out when I"m on the toilet,, I get frustrated and just get up and leave.. figure it will eventually come out. My bad back is making it difficult to use the finger technique at times… so,,,, I just get off the toilet and wait till later. I visited Mayo and the Dr told me to increase my orange fiber drink to 2x a day and with more spoonfuls in each glass. ( and lots of water). This has helped when I remember to stay consistent with it. He did say that he would do the surgery IF this did not work. HE also said NOT to use the fiber pills as the amount of fiber actually in them is not enough. ( I did not know this). Look at the label and see for yourself. it has to be the kind you mix with water. ( more fiber). I am 56,, and never had kids. I also had a bladder sling put in about 8 years ago for incontinence issues. I was told this has nothing to do with my poop problem. ( FYI). Your not alone!

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I'm sorry to hear about your difficulty eliminating. I truly understand your pain and suffering. I've had back pain caused by the unnatural bending/twisting (to reach into my own rectum). I hope the right type of fiber, stool-softener helps!

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