Has anyone suffered faecal incontinence after forceps - but without diagnosis of any tear?

[atrcts]

I had a forceps delivery with episiotomy but was not informed of any tear.

I experienced severe SPD and some faecal incontinence afterwards, luckily the incontinence was short lived but it was a close call for about 18 months afterwards.

I had Physio for the SPD and she gave my exercises to strengthen the anal sphincter as well.

I'm pregnant again and was asked by the consultant if I had torn but I had not been told this, nor had I seen anything on my notes, and certainly the only stitches I was aware of were the episiotomy stitches.

So I wondered if anyone else has experience or knowledge of faecal incontinence without a tear - or is that impossible?

[chocosaurus]

hmm... undiagnosed 3rd degree tears are frighteningly common. if you had forceps and get hence an epis then that is a possibility.

faecal incontinence is not common without sphincter damage.

you could ask for an endoanal ultrasound which will detect any deficiency or past damage. If there was an undetected tear to your sphincter then if further damage occurs you are at high risk of life long problems.
If it was me I'd ask for the scan and opt for a caesarean if old damage detected.
Good luck.

[chocosaurus]

hmm... undiagnosed 3rd degree tears are frighteningly common. if you had forceps and get hence an epis then that is a possibility.

faecal incontinence is not common without sphincter damage.

you could ask for an endoanal ultrasound which will detect any deficiency or past damage. If there was an undetected tear to your sphincter then if further damage occurs you are at high risk of life long problems.
If it was me I'd ask for the scan and opt for a caesarean if old damage detected.
Good luck.

[Ushy]

choco is absolutely right. Sphincter damage causes FI and a further vaginal delivery vastly increases the risk of it becoming permanent. You can also get other problems like a prolapsed bowel etc.

Unless you are mad keen on a further vaginal delivery, I would definitely opt for a c/s.

If you meet any resistance, ask for a referral to a surgeon who specialises in bowel problems.

[atrcts]

Thanks guys SOOO much! I had no sea and it's really helpful to validate what I've actually experienced - it's amazing how easy it is to tell yourself it must be normal for everyone, when it's actually not!

[atrcts]

Should read "no idea" (blimmin auto text!!!)

[chocosaurus]

Your welcome! Be assured that ANY FI is not normal postnatally never mind 18m worth.

Ushy has good advice regarding referral to colorectal team if you encounter any bother.

Stand your ground and try and be well informed. Good luck xx

[herethereandeverywhere]

I had FI for about the 1st 8 weeks post Keillands forceps delivery and slight residual urge/wind issues to this day. I had NO TEAR diagnosed (and I specifically asked the consultant who delivered and stitched me and I know he had his fingers up there checking (boak) but I never confronted the problem properly (didn't demand a referral etc so who knows what the truth is).

So - from my experience it is possible. I couldn't feel a thing from my pelvic floor at all, certainly had no control over it.

I did however have a wonderful ELCS for my second birth - highly recommend.

[atrcts]

Herethereandeverywhere - really nice to hear your second birth was so much better - my 1st birth experience is partly why I have pursued ELCS as my best option second time round, though the surgical recovery is a bit scary (not as bad as 2 years of SPD and 18 months of bowel urgency though!).

I think the bit that causes doubt is the gamble that "this birth might be much better" but the trouble is it might not be, and that's where I am not too happy to gamble again!

[mummy2benji]

Hi there, I'm a GP and have worked in Obstetrics although am not an Obstetrician so don't pretend to have their knowledge. But, in my opinion you are more likely to get faecal incontinence from damage to the anal sphincter or perineal nerve by direct pressure from the forceps rather than necessarily having a tear.

[atrcts]

Thanks mummy2Benji, that's useful to know. Do you know if the damage can be expected to fully recover on most cases?

Like you, I have a medical background but not in obstetrics, and so am a little out of my depth with this one!

[mummy2benji]

I think so, I would have thought that nerve damage caused by pressure would be more likely to heal fully than nerve damage which has been caused by a tear. Again, not sure in this particular circumstance, but dh is an orthopaedic surgeon and I know that nerve damage caused by pressure or crush injuries elsewhere can heal completely within a few months.

[dontcryforme]

Can I resurrect this thread pls?

[Junosmum]

Don't cry for me, you are much better off starting a new one.