TL;DR - have an extremely painful surgery coming up, which is made worse by PFD, and I need advice on what to do!

Hi! First time poster! I have pelvic floor dysfunction / Dyssynergic defecation. I can consume nothing but fiber all day, drink a bunch of miralax, take stool softeners, and still take 45 minutes to go to the bathroom, I have to push to get stool out, and I just never feel like I've evacuated fully.

My fissure is painful and bleeds on and off, and hemorrhoids finally started to prolapse, so I'm having sphincterotomy with haemorrhoidectomy next week. Apparently it's one of the most painful recoveries possible, and it's made much worse with pushing. I'm not sure what do to because I have so much dysfunction, and I have no other way of getting the stool out.

Has anyone been through this before? What did you do? Also, can someone point me in the direction of any resources on how to get poop out without pushing? I'm super scared.

Thanks!

I had a sphincterotomy in 2015 and a hemorrhoidectomy in 2017. The sphincterotomy cured the prolapsed hemmies for a year after the surgery, and the doctor had no idea why. They prolapsed again after that time though, and I was in severe pain because of the internal ones being thrombosed. I'm giving this background because you may find that your pelvic floor dysfunction/dyssynergic defecation will improve or even disappear after your other issues are cleared up on that front like my one issue did, if only temporarily. If the sphincter is working properly (which it isn't now), and the large prolapsable internal hemorrhoids are no longer present, the movement of your stool through the area might normalize. For at least two weeks after my surgeries, I stood up (straddling the toilet bowl) to defecate, and found that was a lot easier and required less "effort". It also allowed me to avoid spreading out the newly healing skin and tissues in the area very much, which happens a lot more when you spread out by sitting on the seat.