LIS and weak pelvic floor

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LIS and weak pelvic floor

Postby msimon » 10 Aug 2014, 16:49

Hi all. Has anyone had the LIS surgery when they had a weak pelvic floor? I have been getting botox injections for pelvic floor dysfunction for years and so it is weak. I am worried what the negative effects the surgery may have considering this. Thanks.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
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Re: LIS and weak pelvic floor

Postby Alyssa » 10 Aug 2014, 18:50

Msimon,

I don't know if you would be the "ideal" candidate for LIS if your muscles are already weak but there are other surgery options that do not put you at greater risk of incontinence (flap advancement surgery).
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
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Re: LIS and weak pelvic floor

Postby msimon » 11 Aug 2014, 21:34

Yeah, the problem is that I have a very tight internal sphincter so I don't think I would heal from the flap. I have also been told that is reserved for very deep fissures.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
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Posts: 1343
Topics: 64
Joined: 08 Aug 2014, 19:38
Has thanked: 76 times
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Gender: Female

Re: LIS and weak pelvic floor

Postby Alyssa » 12 Aug 2014, 00:18

I'm a little confused... So you have a weak pelvic floor but a tight sphincter?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
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Gender: Female

Re: LIS and weak pelvic floor

Postby msimon » 12 Aug 2014, 00:30

Yes, that is correct. Some of my pelvic floor is weak and other muscles are not, especially the sphincters. I am very out of balance right now. It spreads when injected but not that much...
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
Moderator
 
Posts: 1343
Topics: 64
Joined: 08 Aug 2014, 19:38
Has thanked: 76 times
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Gender: Female

Re: LIS and weak pelvic floor

Postby Alyssa » 12 Aug 2014, 00:46

I did not know that was possible... i think my doctor told me that if you have tight muscles then you also have a tight sphincter but I could have understood him wrong.
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
Been thanked: 41 times
Gender: Female

Re: LIS and weak pelvic floor

Postby Alyssa » 12 Aug 2014, 00:47

How was this determined in your case, did you have some type of tests done?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
Been thanked: 41 times
Gender: Female

Re: LIS and weak pelvic floor

Postby msimon » 12 Aug 2014, 02:58

I haven't had any tests done recently. I just know as I have become very in tune with things down there. I did used to do a lot of muscle release rectally before the fissure and could palpate bands of muscle and feel things no longer relaxing. There is one muscle in particular, the puborectalis, which works with the external sphincter. We are supposed to be able to consciously relax these as a unit but sometimes people cannot.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
Moderator
 
Posts: 1343
Topics: 64
Joined: 08 Aug 2014, 19:38
Has thanked: 76 times
Been thanked: 154 times
Gender: Female

Re: LIS and weak pelvic floor

Postby Alyssa » 12 Aug 2014, 11:43

Have you discussed your options with your doctor? Where are you located?
2/14 Fissure developed
3/14 Diagnosed w/ fissure given Nifedipine
4/14 Referred to Pelvic Floor Physical Therapy=Pelvic Floor Dysfunction
5/14 Fissure declared "healed"/chronic anal pain persists
9/5/14 Botox to pelvic floor
9/22 biofeedback
Alyssa
VIP
 
Posts: 735
Topics: 26
Joined: 29 Apr 2014, 11:24
Location: San Jose, CA
Has thanked: 136 times
Been thanked: 41 times
Gender: Female

Re: LIS and weak pelvic floor

Postby msimon » 12 Aug 2014, 13:22

I am located in Edmonton, Alberta, Canada. Our health care system here is painfully slow and we have very few people, including physios, that treat chronic pelvic pain. I am in a clinic program now that took me 2 years to get into...

The Doctor at this clinic is away until September but I will hopefully get to see her soon. Although, the problem with these things is that no one Doctor treats all these issues. In fact, I think my last one discharged me because she is a urologist and did not want to treat rectal issues anymore. This Doctor at the pain clinic is a gynecologist and the rectal stuff may be a stretch for her. My CRS will only treat the internal sphincter. I could get anal manometry done soon but I had it done before and ultimately amounted to nothing. I was not able to get the balloon out but there was no follow up after. Not to mention, with the current fissures I have would be a huge step back. No thanks.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
Moderator
 
Posts: 1343
Topics: 64
Joined: 08 Aug 2014, 19:38
Has thanked: 76 times
Been thanked: 154 times
Gender: Female


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