DECISION TIME FOR SURGERY BUT WHICH ONE?

[Sandra2468]

SYMPTOMS

I BEGAN 5 YEARS AGO WITH HAEMORRHOIDAL SYMPTOMS, A STRANGE PUSHING SENSATION IN MY ANAL CANAL, AND CHANGE OF VERY REGULAR BOWEL HABITS. NO CONSTIPATION, NO BLEEDING, AND NO ITCHING.  THIS PROGRESSED TO PROCTOGRAM SHOWING PROLAPSE IN ALL 3 DEPARTMENTS BUT WAS TOLD ALL WAS WITHIN LIMITS FOR PROLASPE. THE DISCOMFORT/PAIN WAS SO EXTREME THAT I THOUGHT I HAD AN ANAL CANCER.

LIKE MOST WOMEN HERE I HAVE BEEN AROUND THE WORLD TRYING TO FIGURE OUT WHAT I HAD AND IT HAS BEEN A CONTINUING NIGHTMARE.

MANY LADIES ON THIS SITE HAVE HAD UNSUCCESSFUL SURGERIES THAT HAVE EITHER CAUSED NERVE PAIN OR HAD NERVE PAIN FOR OTHER REASONS. I AM HOPING THAT SOME OF YOU MAY BE ABLE TO GIVE ME SOME ADVICE.

This is where I am at now:

 1. Early morning low back pain which refers into my anal region. I do not take medication as I am pain free with my back when I am up and mobile.

2.  Horrendous discomfort in anal canal when sitting. It is discomfort I cannot live with as it disturbs my quality of life.

3.  Incomplete evacuation with a need to wipe

4.  Mid grade inutussusception (internal rectal prolapse) shown on proctogram

5.  Mobile womb at entrance of Vagina (no dragging at end of day) which is usual with full blown prolapse, and no tissue escaping. Also no dragging in the anal canal at the end of the day, but 24/7 mild discomfort relieved when standing and walking.

6. Large bladder well down (no leakage)

7. Pelvic or sphincter exercises impossible with anal discomfort

8.  Ring pessary does not make a difference

9.  Some faecal urgency and occasional accidents

10. Suffered with lots of flatulence over the years.

11. Possibly lactose intolerant.

Condition worsening

Opinion Gynaecology

Hysterectomy and anterior repair. Or mesh suspension surgery.  However a later anal surgery may be needed.

Opinion Colorectal

Possibly some banding, HALO surgery. EUA under examination. Ventral Rectopexy and possible sacracolpopexy.

I realise that many ladies have had complications on this site with regard to nerve pain.  I am now after 5 years getting worse and this is effecting my quality of life. I am also not wanting to end up with Constipation which I DO not have as yet, although I am beginning to think my mild faecal continence is sometimes working in reverse at times and verging on constipation.

From my understanding the Ventral Rectopexy lifts the rectum and the bladder. By keeping my womb this is helping support the organs. However this surgery is not lifting the uterus and putting it into its original position. The add on sacralcopexy surgery lifts the neck of the womb, but not the complete uterus.  I have no idea if I CAN have a hysterectomy after the above surgery at a later date. 

Has anyone had the above surgery with my problems?

With regard to hysterectomy and anterior repair. 

Has anyone had this surgery with good results. 

Also has anyone had a very good scanning for these areas apart from proctogram?

For some reason colonoscopy, and proctogram are the only scans offered.

I have had in the past a MRI pelvis but I do not think it was zooming in on the bowel, bladder region!    I had the scan for other reasons such as lumps near the sciatic nerve which have remained stable for 12 years, with no nerve pain down the leg.

There are no guarantees that these lumps may not be contributing to this but the stabilty they have shown with no growth and no pain down the leg is very positive.

And I am sure the lumps are a red herring.

Best wishes,

Sandra

 

[Mc89]

I can't help you with which surgery to have but just wanted to ask if you've had an anorectal manometry test? I don't get pain as such but a horrible pushing feeling there. I knew I had a rectocele but have now found out I have very weak anal resting tone. I don't know if this test would help you but it shows up different things than the MRI proctogram. 

I had an anterior repair & hysterectomy 3 years ago, they told me then I had a small rectocele but would not repair that at the same time. I feel the rectocele has got bigger since the other surgery as my bladder was holding it up (& my consultant agrees). I will need the posterior repair done at some point but am worried that it might lead to yet another problem.

It doesn't help that gynaecologists & colorectal consultants don't seem to get on! It's so difficult making what is a very important decision when you get so much conflicting information. I wish you well & hope you get it all sorted soon. 

[Sandra2468 in reply to Mc89]

Thank you M for getting back to me really appreciate.

I have had an ano-rectal physiology test and a endo-anal ultrasound 2013.

This demonstrated poor squeeze increments and hypersensate rectum.

At that time I did not have incomplete evacuation and my condition has worsened.  I know I need a surgery, but also realise that mesh surgeries can give way to complications such as mesh erosion and may be nerve pain.

With regards to your surgery hysterectomy and anterior repair and the feeling that your rectocele has worsened is exactly why these ventral rectopexy surgeries were developed.

But none of these surgeries are without risk.

Thank you for contributing to this posting.

Sandra 

[shirlygirly]

Hi Sandra, Your symptoms sound very like mine, I had IBS for years

and eventually 5 years ago I had  Proctectomy due to Rectal Prolapse.

Im now left trying to cope with what is left of my bowel, no advice or

do and donts, just get on with it,  Largely I cope very well but when it

goes pear shaped, oh dear! Its very hard.

Good luck with what you decide.

[Sandra2468]

Shirl;ey,

Thank you for your message. I realise most ladies on this forum have pain issues and problems. 

I'm sorry this all led to a proctectomy for you. 

I wish you all the best and hope the following years will get easier for you.

Just wondering if any ladies have had a joint surgery for prolapse issues?

With some success!!

Sandra

[shirlygirly]

Thanks Sandra, Sorry Im  bit down! at the moment, I do hope you

find the perfect solution to your problem very soon.

Shirley.