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.