Mumsnet has not checked the qualifications, experience, or professional qualifications of anyone posting on Mumsnet Talk and cannot be held responsible for any advice given on the site. If you have any serious medical concerns we would urge you to consult your GP.

Calling all Raggedies - the THIRD Ragged Bits thread. Childbirth injuries, sphincter problems, fistulae... all welcome.

(769 Posts)
Jacksmania Fri 26-Oct-12 19:08:26

First thread here, May 2008 to June 2009.

Second thread here, June 2009 to Oct 2012.

Welcome everyone with ragged bits due to childbirth. We're sorry you had to find us, but we promise to hold your hand and listen.

There is no TMI here and nothing is too gross, too embarrassing or too horrible.

<lays out tea tray, buffet and alcoholic bar>

All welcome.

CSRHP Tue 15-Apr-14 03:04:26

Thank you for your support cardamomginger and cravingcake! I will keep you up to date. Hopefully with good news

cardamomginger Mon 14-Apr-14 08:40:40

so sorry you didn't get the answers you were hoping for. to be told 'we don't know' is horrible. what's the plan going forward? as for the perineum, it can be fixed. have they scanned to see what muscles may be torn? as for why - what often happens is that they use a suture that doesn't last long enough for muscle to heal, so it opens up, even though the skin (which doesn't take as long to heal) does close (more or less).

I'm sorry sad . xxx

kianaidan Mon 14-Apr-14 07:46:46

Had my EUA friday. Colorectal have said they can.t see a fistula but my perineum is thin. And also mentioned a lot of scar tissue in the front as was examined botg front and back. Still no explanation for vaginal gas and rectal bleeding during menstration so I.m to go back to see colorectal in 6wks time. I can.t say I.m not worried about the perinium part and don.t understand how this is the case after 3 2nd degree tears the last being sutured bya midwife.

cardamomginger Sun 13-Apr-14 19:49:13

sweetheart sad . I know. all of us here know. the shock and devastation of being broken so horrifically, in such an intimate place, through doing something 'normal' can be unbearable. it's even harder when you look at other women who just breeze through it. can you get some support through counselling? no, it doesn' t solve the reality, but it can help you find strength to get through it. I've found emdr trauma therapy very helpful.

I don't know of anyone who's had the repair. when you know what the surgical options are, talk it through with your surgeon. maybe with the urogynae as well. ask for a second opinion if you want it. ask them about the risks, failure rates, success rates, long term data for the procedures.


CSRHP Sun 13-Apr-14 19:37:38

Yes i am see a urogyn, he was the one who made me aware of my structural (significant defects) sad..... Biofeedback def is helping a little. Do you know anyone who has had a ruptured/torn sphincter and still manage to be continent when they are older in life? I'm only 29, and the reality of this is more than i can handle...

cravingcake Sun 13-Apr-14 18:50:56

CSRHP this is much easier said than done but try not to worry, any new information can be hard to take (good or bad) so dont panic yet. Take time to cry, be angry, frustrated, or ignore it for as long as possible - whatever you need to do to cope. Everyone on this thread has been through or is going through the roller coaster of emotions and physical problems that make us Raggedy.

I cant offer any practical advice but do extend a hand to you, and all the other Raggedies that have recently joined us.


cardamomginger Sun 13-Apr-14 14:04:03

sad.Wait until you have had the scans and you know the extent of the damage. Are you seeing a gynae surgeon too? I think rebuilding your pelvic floor muscles is easier and less risky than trying to rebuild sphincter muscles, so that might be something to do first. That plus physio and biofeedback might help you. I'm sorry. I know what it's like when the problem just gets bigger and more complicated. sad xx.

CSRHP Sun 13-Apr-14 12:28:27

I just ran into my colorectal at the hospital yesturday. I asked him about my sphincter muscles which he finally said he does have clinical suspicion that there is a tear and weakness. Now i'm all broken again. I just don't know what to do. I want my perineum fixed, but i wonder if i should leave it for when I need sphincterplasty? So lost, hurt and sad.....

cardamomginger Sun 13-Apr-14 09:05:47

the repair of the muscle under the oerinuem skin was done through the vagina at the same time as a whole load of other prolapse repair surgery. I won't lie - it was bloody painful. pulling together 2 ends of a muscle to close a 3cm gap hurts!! my surgeon injected the muscle with a long acting local to try and help with the pain and with botox to try and stop it going into spasm - this can happen when you close a large gap. the muscle is fully functioning now - strength is symmetrical and I score almost 4 out of 5 for strength. continence is much much better. no accidents. wind is still a bit hit as miss, but it's getting better as strength improves.

I didn't have anything done to the sphincters. I think they prefer not to unless they really gave to and as I didn't have any actual tears there was no need. biofeedback was suggested for me too. at the moment I just can't face it. after 3 major ops, 2 minor, masses of gynae physio, severe PTSD, etc, sticking something up my bum is so not what I want to do right now! I might revisit this, but I want to see how far I can get without it.

sex is not on the agenda right now. lots of reasons. some physical, some PTSD related, some because my relationship with dh is shot to bits. I'm not the best person to ask, and in any case I'm an extreme case so my experience is not the norm. the perineum rebuild, however, hasn't impacted on the no sex situation. that's been fine.


CSRHP Sat 12-Apr-14 03:30:16

I somehow needed to create another account so I was catia108 now i'm CSRHP, just in case anyone is confused. Again thank you so much, it helps to know there are other women like me out there!

CSRHP Sat 12-Apr-14 03:27:09

Cardamomginger, thank you for your comments. My appointments for my analrectal physiology tests have been cancelled until next month so now i have to wait. So you too had no muscle between your rectum and your vagina? how was the repair surgery? And with your sphincter muscle was that surgically fixed as well or did you get better with therapy. I am doing biofeedback, which seems to help I can walk and hold my wind sometimes now.
How is your continence now? And now with the surgery you have a perineum again? is sex painful? Thanks for all the answers in advance.
Im so happy i found this site!

cardamomginger Fri 11-Apr-14 10:39:04

So sorry to all of you. sad and thanks . Am on my nexus, so can't look back and see who posted what, so can't direct my comments to individual posters. But hopefully you can work it out!

It makes me so angry that you have both had such dismissive attitudes from your gynaes. There is no reason at all why you should have to live with these severe symptoms. PFEs are not going to solve such dramatic urinary incontinence - surgery is the only thing that is going work. Can you get a second opinion?

I also had a paper thin perineum because my tear only healed (incompletely) at the skin level. I had no muscle underneath, as I had a 3cm gap. It was fixed and now it is OK. I had sphincter damage, although no tears, and this meant I had faecal incontinence and couldn't hold wind. The hincter was stretched and weakened during burth. What tests have you had? They need to do a endoanal ultrasound and anal manometry. the first will show if the sphicter is intact (and will also show if you have a gap in your pelvic floor muscle). the latter will show what the muscle strength is. Since having my prolapses repaired (cystocele, rectocele, entwrocele, uterine prolapse) and my pelvic floor muscles repaired, things are much better and I've been able to do physio much more effectively to build up my strength.

on holiday with patchy internet, but will do my best to keep up with this thread! xxx

Jacksmania Thu 10-Apr-14 23:04:01

Hello newbies. Am at work, will return and read as soon as I can.
You're among friends here smile

cake and wine or brew as required for all.

catia108 Thu 10-Apr-14 20:33:29

Hello Everyone,
I am wondering if anyone else is living with no perineum (Mine is extremely paper thin). I have my first child two years ago via c-section, he was stuck. I just recently had my second child in november vaginally. Everything was going well. I was told i had a second degree tear, which was sown up. However as time went on, I would notice i had trouble with controlling my gas. When I went back to work, I notice I had incontinence of very small amount of loose stool. I was mortified and extremely depressed. I called my OB who suggested i see a Urogyn.
And there is when my nightmare began. I was very hopeful prior to this. So I was told there that i have an anal sphincter tear. I was also told that I have a paper thin perineum (my nephrologist said its non existent). the urogyn said based on my age and the severity that I should definitely get this fixed. So I went to see the colorectal surgeon. Upon exam he made me feel better and said I would not need the sphincterplasty now. We are going to do more tests to be sure. I asked him about getting my perineum fixed, which he said "Don't let anyone do anything to you down there" He believed my sphincter muscles are intact (I think), but are really thin and weak. Surgery could cause a problem. So I am happy with what the surgeon said, however, what about my perineum. My anus has literally moved towards my vagina.
Does anyone have this problem. For how long, does it affect you sex life. I am soo freaked out by how i looked. I am getting so depressed.... I don't want to be defective my whole life...... But i prefer to be continent (Although now i shart and have diff with gas).
Any words or suggestions would greatly help!

learnasyougo Thu 10-Apr-14 13:10:08

pphello, your experience sounds remarkably like mine (even down to the urogynae who doesn't give a damn. seeing him was so depressing. you're not in the southeast by any chance are you? I'd hate to think there were two urogynae who made their patients feel so bad)

my incontinence was a combination of nerve damage following a difficult birth with ds1 (72hr labour, forceps and episiotomy. his head circumference was off the scale - over 100th centile - and the pain during labour was also far beyond normal contraction pain. In hindsight it was nerve damage) and pelvic floor weakness. did my exercises diligently (70-100 per day once I had sensation back) led to some improvement but not that great, still.

I have a cystocele and urethrocele they are very noticeable from the outside though urogynae with the arsey attitude wasn't even going to tell me that. I had to press him on it he was just dismissing me with 'it's your pelvic floor' (leaning back in his chair, waving me away with his hand)angry

sex life is screwed. I have given up on orgasms. sex is for dh only now. and it leads to me having a painful, heavy feeling for a day afterwards. I cant bear to stand or walk for too long because of the pain, which makes me unlikely to ever initiate sex.

Had Ds2 recently so after 3 months of pfe (I have a new referral to physio. I was too cowardly and embarrassed to have pf function measured last time) and then I'll have to bite the bullet and see the rude urogynae again.

I also feel I have a gaping fanjo. pfe made some difference in tightness and incontinence but second pregnancy has set me back. I sleep in adult nappies as I have a cough at the moment. even with wee shooting out with each cough, when I get up first thing I run a continuous leak all the way to the bathroom. its beyond stress incontinence. I hope physio can at least get me back to just the cough and sneezes incontinence because this is depressing.

cardamomginger Wed 09-Apr-14 09:39:07

Hi pphello - also extending a warm hand and so sorry you have had to find us.

Sounds like you definitely have a prolapse, definitely have a poorly and incompletely healed episiotomy, and may have some muscle damage as well (did the gynae say whether there was a gap in the muscles of the pelvic floor as well as the skin - a poorly healed episiotomy can mean that that it's not just the skin that gapes, the muscle layers are also open). ALL of this can be repaired surgically. Physio will help you to build up muscle strength before surgery, and will do a lot to help you post surgery, but I doubt it will do anything to solve the problems you have got. It's possible that the gynae has 'decided' that you will 'obviously' be wanting more children and that for this reason they prefer to wait until after you have 'definitely' completed your family before operating and that this is why they just said to go away and do physio. (BTW - it's really not true that you can't have surgical repairs if you still want more kids.)

I think you need to go back to your GP and ask for a second opinion. I'm trying to search online to see what the cut off point is for physio before they 'decide' that it hasn't worked and consider other treatment options. I can't find it, but I think it might be 6 months. So if you can hang on until then and then go back to your GP, then you can say 'look, I've been doing it for the recommended time, and it's still not doing anything'. (Not suggesting that you carry on with the exercises - just trying to get the boxes ticked, IYSWIM.) I think you need to impress upon your GP just how devastating this is for you and how intolerable it is to continue to live like this. I think they don't always 'get it'. Also stress that you have been doing the physio exercises religiously and that she also used electronic stimulation to kick start the muscles, and your symptoms are unchanged.

It's shit and it sometimes it feels like the end of the world. I'm not surprised you are crying so much sad. But it does get better. Surgery helps enormously and the right physio at the right time can also do wonders to build up the muscles again and to get the nerves firing properly. (Sounds you like you have a bit of nerve damage too, if you say you can't feel anything. This gets better too - nerves just take a long time to recover and sort themselves out again.)

If you are in London and are able to go privately, I can recommend my lovely lovely surgeon who will take you very seriously indeed. But I appreciate that this might not be an option.

So so sorry sad. XXX

cravingcake Wed 09-Apr-14 04:42:09

Welcome along pphello, sorry you had to find us. Wow, that sounds like either errors or things were missed along the way. Feel free to rant as required, its so frustrating when the medical staff say oh its just x y z. The good news for you is there is surgery you can have - perrenial refashion i believe is the term generally used. Its exactly as it sounds, cut and restitch of the perrenium but that will only fix the gaping part. It sounds like you need to get the prolapse fixed as well, probably at the same time. I have one too which now (11 weeks post second baby) feels worse than before. Some of the ladies have experience of this on here but there is a prolapse thread as well which you may get more info from. I'll be heading over there once i finish breastfeeding as i cant live like this forever.

I have read that episiotomy's can heal open as well so thats possible, the scar tissue of mine certainly feels very wide or that could be my big arse stretching it

Theres no TMI or stupid questions on this thread either.

pphello Tue 08-Apr-14 01:48:42

Hi there - i've just found this thread, hope i can join.
I've got 2 children 4yo and 15mo. Both episiotomies following long labours, 4yo was 72 hours, had forceps too.
Since birth of my youngest i've had 'issues' that I thought were normal and i'd bounce back as i had previously. Stupid ignorant person that I am.
When bending to clean the showerscreen daily I'd pee myself. I ended up seeing a womens physio who said that yes my pelvic floors were useless (I couldn't hold more than 2 squeezes before my muscle was fatigued she said). After 4 months of her spending more time between my legs than my husband, whilst giving me electrostimulation I finally felt confident that I could live my life without pee'ing myself.
THEN I stopped breastfeeding at 10months and not sure if it was hormones or what but when my period returned it felt like my insides were falling out. I raised with with my GP who have an internal and said she thought I had a prolapse. If I can manage to get a tampon in it will fall out as soon as I get into a sitting position.
3 months later I finally saw a urogynaecologist who said I have grade 1-2 rectocele and cystocele and a 'gaping' vagina which if I impoved my pelvic floors it'd hold everything in and i'd not have a problem anymore.
Sounds so simple huh! But how when i've already spent months seeing a physio?
I left the office in tears and I still cry multpile times a day thinking about it. I can't live like this anymore. Its the 'gaping' that annoys me more than anything else. I have NO sensation down there at all. s*x life isn't we dont have one anymore now. I can't feel anything, husband is quite well endowed and he said it just feels lost in there ;o(
Since my appt a few weeks ago I've been paying more attention to my body than I had before. When i wipe after peeing my fingers actually go inside my body, and looking at my bits it is just open!
Its made me think perhaps my episiotomy never healed properly?
My youngest was verrrry bruised when I pushed him out. I spent an hour pushing before epi and turns out he was coming out face first not top of head. Needless to say I was very bruised too. It felt like I had a scrotum ha!

Sorry for the long winded vent above...just wondering what you all think?
Can an episiotomy heal open, hence why I have the gape?
can it be recut and stitched? I'm not having anymore children.

I shoudl have asked at the specialist but the appt felt very rushed and it was as if my problem isn't severe enough for them to worry about.
I'm the life of an elderly lady with a share in tena ;o(

Thanks in advance x

Neptuna Thu 27-Mar-14 08:50:49

That's fantastic you've no signs of PND again! Very positive! I understand the feeling of missing out on all the little moments with your DS. I don't remember much about those early months at all. It's kinda upsetting to see newborns now cause I can't recall that period at all, which is unusual for me as I've got a pretty good memory.

When you say you're feeling more confident in asking for the operations/treatments you need does that mean you're thinking of having a procedure done?

Glad to hear things are going so well!!! Hope they continue to get easier and easier grin

cravingcake Sun 23-Mar-14 20:09:03

Starting to settle down into a bit of a routine now, generally everything is going well and i dont feel any signs of PND. I can now fully understand just how bad things were first time around. It also means i can fully appreciate all the little moments with my DD that sort of flashed by in a blur with my DS.

I can manage the physical problems alright for now as i feel very confident in asking for the operations/treatment that i need (but not until i've finished breastfeeding and let my body settle down). Most of that has been from the support i've had from this thread, so a soppy thank you to all that have helped me.

kianaidan Sun 23-Mar-14 08:12:41

Muriel -I will do but also feel free to inbox me any questions u have. I have a minor prolapse too, not been told which type but think it may be rectocele.

Neptuna Sun 23-Mar-14 04:55:30

Oh kianaiden good luck for your procedure, at least you'll be out to it so will have no memory. If they do find a fistula there are amazing reconstructive techniques these days, I'm sure you're in good hands.

Cravingcake hope the fissue heals soon. Be sure to let your GP know how it's going, you don't want to have to see a colorectal again if it gets worse! How's bub going? And how are you feeling emotionally about everything? I think I remember you said you had PND after the 4th degree tear and were worried about it coming back this time?


MurielHeslopp Sun 23-Mar-14 01:02:44

Good luck kianaidan please keep updating on here. I'm worried I have a RV fistula but too scared to see a doctor about it. blush
I'm also pretty sure I have rectocele. sad

kianaidan Sat 22-Mar-14 20:14:16

Yes just daycase.

cardamomginger Fri 21-Mar-14 15:05:22

Well done. Will it just be day case?

Join the discussion

Join the discussion

Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.

Register now