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

Posted by flind @flind, Mar 7, 2020

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!

@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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@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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I've read that they sometimes recur even after successful surgery. I hope this is not the case for you! Thank you for sharing your experience!! It's helpful to know what to expect (or what post op might be like)!

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@flind

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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Just a bit more background on my particular set of circumstances:
Since my constipation was due to medication, nothing helped until I stopped the medication. I had years to experiment with laxatives and the like. My inclination as an otherwise healthy person was to eat well and exercise regularly. What I found is 'at best' I would experience 8-20 days of marble-sized 'pellet' poop (some of which invariably stayed stuck in my rectocele until I manually removed it) interspersed with an occasional 'miracle day' of a pretty ordinary (but occasionally runny) poop. I thought I might have mild Chron's disease but my symptoms didn't fully match. But my point is – whether I hiked, biked, ran, played tennis, whether I ate salads and high-fiber vegetarian all week, whether I fasted or ate steak – NOTHING altered the pattern – Until I stopped the anti-depressant. My constipation eased immediately when I began tapering off that medication. Now that I'm 100% medication free I have wonderfully 'average' bm's again! Instead of every week or 2, I poop every day! And no more 'pellets', but normal consistency.

Medication can be literally life-saving. But constipation is no small matter as a side-effect. I wish biochemists or whoever creates these drugs would take this side-effect more seriously – especially when it can create conditions requiring surgery! Throwing more drugs eg stool-softeners on top of the problem is not imo a solution.

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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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Thank you for sharing your experience and for all the great information re doctors and surgical procedure! It is reassuring to know I'm not alone. And good to know others ARE talking about rectocele – I need to change the title of this thread 🙂

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In reply to @rarelybees2889 "What exactly is it?" + (show)
@rarelybees2889

What exactly is it?

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Good question, @rarelybees2889. I did some research on Mayo Clinic's website and came up with this article. It explains rectocele quite well. Just click on the link and you will find some interesting information, https://www.mayoclinic.org/diseases-conditions/rectocele/symptoms-causes/syc-20353414

Do you have symptoms that might indicate that you have this problem?

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I have had 3 surgeries for vaginal prolapse that included rectocele, cystocele and enterocoele. How much of each I don't really know but I do know that the rectocele part of it is the worst and what I notice. Honestly I think all of it goes together and I don't know of anyone personally who has one without the others. I had one surgery in late 2013 and I could see it so obviously like a dome at the vaginal opening, then had a reoccurrence in early 2015 after a bout of the flu or a bad cold and I coughed like crazy for 2 weeks straight then one evening I felt something "give way" on the inside then felt something fall in. The coughing had created another relapse and again I had one in 2016 after only 3 months that I live with now. I have just turned 68. I do understand about the constipation issue that I manage with a very close to vegan diet. I do eat some sugar but no meat, I have switched to gluten free and a low FODMAP plan to eliminate foods that I have had trouble with in the past. I learned a lot about irritable bowels. I take Miralax daily and also Agiolax which is like the old Perdiem that I took for many years at the suggestion of my gyn doc back when I was 40 years old. I have always had a nervous system and it helped me so much it was like a miracle cure then was discontinued and I struggled for many years which I do think contributed to the prolapsing. I also drink a minimum of 1 liter of water per day. I have had some serious traumatic things happen in the last several years which don't help so I work through the stress related physical symptoms of all that as well. I am learning to live by, "To thine own self be true." I have never done that but I am slowly learning to put my own life and concerns before the rest of the people in my life. I am not a candidate for more surgery so unless they come up with a new way to fix the prolapse I will have to live with it and I can do it as long as I am careful not to become constipated for very long. It does happen and it lasts about a week when it does. Then I add Milk of Mag or the Dulcolax variety of Milk of Mag which is the same thing. The pandemic and staying in so much hasn't helped either because I don't walk all the time like I used to living in NYC – I was out and about all the time. I do what I have to do to take care of myself and to be true to me.

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