LIS scheduled for Tuesday -- but what about rectocele?

should i ask for both surgeries at once?

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LIS scheduled for Tuesday -- but what about rectocele?

Postby QuirkyJ » 12 Jul 2014, 12:08

Hi all, I've been struggling with a very painful fissure since the end of May. I've been prone to hemorrhoids for a long time -- started getting them 9 years ago with my second pregnancy, and during and after both my second and third pregnancies were pretty much hell with painful thrombosed/prolapsed hemorrhoids. By the time I got around to seeing a specialist, though, they were much better and it didn't seem worthwhile to get hemorrhoid surgery given the risks and relapse rates.

It took me a really long time to realize that it's not normal to have to splint to have a bowel movement (i.e. put a finger inside my vagina to press on the back wall to enable the BM to come out). After some Dr. Googling, I realized I had a rectocele. I went to a gynecological surgeon and got fitted for a pessary, and discussed rectocele surgery if the pessary didn't work out. Not long after that though I blew out with a painful fissure and got a referral to a CRS.

My CRS is great -- has been very responsive to phone calls and fitting me in when I was in so much pain I couldn't function, even though her schedule is always overbooked. I'm in a large metro area and she is very well regarded and thus very popular I guess. I tried nifedipine cream, which seemed to make the pain worse, and bulking up my diet with supplemental fiber (I already eat a very high fiber diet), and muscle relaxants (Flexeril and later Zanaflax). Still couldn't function with the pain and had to work from home for weeks (thankfully I have a wonderful boss). Nothing has worked for the pain except 800 mg a pop of ibuprofen and Percocet -- Tylenol 3 and Vicodin didn't touch it, and the spasms last hours.

I am booked for exploration under anesthesia and an LIS this Tuesday July 15. I have no doubt I need an LIS -- my inner sphincter has spasmed so hard and so tight that I can barely insert a glycerin suppository. But I am really worried that the AF is just going to recur if I don't get the rectocele fixed. I think what happens is that because my rectum is distended with the rectocele, there's not sufficient muscle tone to get the BMs out, and I have insufficient emptying, so I tend to get a plug/constipated bit. I think the rectocele is the root cause and the AF/spasms are really the symptom.

The surgery has all been scheduled in kind of a rush -- I got in to see the doctor last week on a standby appointment when I was just debilitated by the pain, and she fit me into her surgery schedule and it was either now or wait until September or beyond, so I chose now because I can't make it through another two months with this pain. But I don't feel like I know what the plan is and whether it makes sense to ask to get the rectocele corrected now or wait and go in again when I'm healed from the LIS.

Sorry this is so terribly long-winded, but if anyone has any experience or advice to share about the pros and cons of rectocele and LIS surgery together or separately, I'd be grateful.
QuirkyJ
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Re: LIS scheduled for Tuesday -- but what about rectocele?

Postby owmybum » 14 Jul 2014, 16:52

I think this surgery is usually done separately. I know a board member on here had a flap done, then a few weeks later had the rectocoele dealt with. The best thing would be to ask your surgeon the morning of surgery.

All the best for your surgery, and fingers crossed for a speedy recovery!

OMB xx
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Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: LIS scheduled for Tuesday -- but what about rectocele?

Postby QuirkyJ » 14 Jul 2014, 17:06

Thank you! I am nervous but reading this board had really helped assure me that I'm doing the right thing and that recovery is likely to be less painful than the fissure. Fingers crossed!
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Re: LIS scheduled for Tuesday -- but what about rectocele?

Postby owmybum » 14 Jul 2014, 17:15

Yes.... It seems to have great results.... You'll do great!

Keep us posted!

OMB xx
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: LIS scheduled for Tuesday -- but what about rectocele?

Postby QuirkyJ » 16 Jul 2014, 16:24

Update -- had surgery yesterday with LIS and cleaning up the edges of a very deep fissure and putting one stitch in. Done with IV sedation and local anesthesia but thankfully I was completely unconscious until I woke up in recovery. I have had so little pain it's like night and day. Even had 2 bowel movements today and tho I did sitz baths after each I had no spasms at all!! No need for any muscle relaxants at all. I cut my Percocets down from 2 to 1, going from every 4 hours pre surgery to every 6-8 now. I'm also taking ibuprofen for swelling which was annoying yesterday but very much reduced today. I slept a lot yesterday afternoon and last night, but I am feeling 100% better.

I may need to follow up with physical/biofeedback therapy depending if my outer sphincter continues to spasm but so far so good no spasms yet. And it is so amazing not to be in constant pain to the point of not being able to sleep even with pain meds!

I will say the two enemas were brutal. No fun at all and extremely painful although I understand the necessity. But honestly those were worse than the actual surgery. In hindsight I am convinced that surgery was the right choice for me as I don't think there's any way at all the fissure and spasms would have healed otherwise.

It's still early days and I am going to take it easy and be very vigilant about my diet and water intake, and when I have healed I am going to pursue getting the rectocele fixed as I think it led directly to the fissure, but I am so happy to have the LIS surgery over with and get started on the road to recovery.
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Re: LIS scheduled for Tuesday -- but what about rectocele?

Postby QuirkyJ » 26 Jul 2014, 17:44

So I am almost two weeks out, still having occasional bleeding but it's from the wound, not when I have BMs. It's mostly not painful, but I do get twinges of pain and there have been a couple of days where especially late in the day it's been pretty sore. Hot baths, a heating pad, and especially a hot water bottle at night have really helped at those times.

I took a look at the wound site today and I'm just wondering if/when everything is supposed to heal up and over. I have a pretty wide upside-down-V shaped wound extending upward from the 6 o'clock position. Honestly looking at it grossed me out a lot and I am amazed it isn't very painful -- it LOOKS like it should be a very painful open wound!

Anyone have any experiences in terms of how long the healing took? I assume it has to heal from the inside out, but I'm a little freaked out at how wide the gap is in the upside down V as I just don't see any way that those edges are going to come together.
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