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Spincter injury, fistula - support eachother?

(959 Posts)
Cyee Tue 13-May-08 20:22:44

Hi everyone,

Wonderful weather we're having

I am propped up in bed post-hospital and I was wondering if anyone out there knows of, or would enjoy/benefit from, a thread or support site for people who have experienced the above (sphincter damage, fistula etc.) as a result of childbirth.

In my own experience, this whole area is a bit taboo. In fact the consultants reckon there are many women who have some symptoms related to the above, who never seek treatment. The thought of women embarrassed to discuss these matters is awful, yet that seems to be the case.

So - this (while souped up on painkillers) is a call to arms:
- Is there a site out there for women like us?
- If not, would you like there to be?
- Would a thread on MN especially for this, be useful?
- Would it be useful to share experiences with consultants/physios/hospitals/procedures?

If these matters resonate with you or anyone you know, it would be great if you could point them in this direction. I'm going to post in the 'health' and 'childbirth' sections too.

I know too well the taboo around this. I posted on MN when I got my diagnosis and used a different name...

Hope to hear from some people soon.

(successfully repaired as of last Wednesday (fingers/legs crossed))

cupsoftea Tue 13-May-08 20:24:31

just to say I hope things will be ok soon xxx

milkgoddessmakesthefinestmilk Tue 13-May-08 20:26:41

hi, i had a 4th degree taer when having dd 11 months ago.

Cyee Tue 13-May-08 20:35:20

Thanks for the posts (I do get excited when a new one starts!).

MGMTFM - are you fully recovered now? Did ou need post birth surgery or was it done there and then. Hope you're well!

Thanks for the good wishes COT

milkgoddessmakesthefinestmilk Tue 13-May-08 21:18:13

i was taken into the operating theatre after having a drug free water birth, given a spinal tap, and a repair op.

im not really ok now, as it feels painful still, the scars rub and hurt and i can;t even wear nice knickers anymore,
the scars rub when i walk and it feels like pubes are caught, that kind of sensation.
also it affected me mentally too.

what happened to you cyee, ps you can call me milky if you like its a bit easier than mgmtfm

Cyee Tue 13-May-08 21:42:14

Hi Milky Yep, that's easier.

That must have been such a shock for you after the birth...

With me, I had G&A and a pretty straightforward time, in fact I delivered her (10mo now) in 11 mins! It was only about 8 weeks later that I realised that there was a problem - basically I had a tiny little ano-vag fistula and some sphincter damage that needed to be sorted. I went in for the op last week and.. well.. the op seemed to go well and I'm just waiting for soreness to pass...

Have you seen your doc or a consultant about your scar tissue and discomfort? Is there anything they can do about it? I have read about people's pubes being accidentally caught up in repairs and that they can 'cut them free' so to speak.

It's awful, the way you end up feeling about your body. Did/do you also feel a bit yuck when it comes to intimacy etc.?

DMCT Tue 13-May-08 22:18:38

Hi guys,

I had my baby 6 weeks ago, i had an episiotomy then fourth degree tear - due to forceps, the worst experience of my life. Was taken to theatre after the birth and was there for about 2hrs. Things havent gotten much better with control etc since. I am still v sore and have a variety of things happening to me that, leave me feeling not very good to say the least. I dont think i'll ever be the same again.

I am waiting to hear from the specialist and have been told i will need surgery to repair it again.

I feel physically sick about the whole situation. i had a checkup 3 wks after and freaked - i just couldnt let them examine me.

I hope your surgery went well and if there is anbything i should be asking them/telling them please advise

milkgoddessmakesthefinestmilk Wed 14-May-08 09:31:53

my heart truely goes out to you both, i wish you both the speediest recovery.

dmct, when i was only 6 weks post birth i was still in such a state of shock,[still feel a bit shocked anbout it all now tbh] i feel so much for you.
are you getting much help form those are you?
do you know yet, when you will be havin the 2nd operation?
when i was waiting for my follow up op i felt like a black cloud was hanging over me, so i can only imagine how scary it must feel for you.

cye, how are you feeling today? not so sore i hope? how did they do the op? where you awake or did you have a ga?

yes it ws a shock for me as i thought the birth went so well, i was so calm, i didnt even find it that painful tbh, i delivered the platenta naturally, so one minute i was having/had a totally natural drug free calm water birth, then after the platenta was delivered and i got out of the pool, then they realised what had happened. it was panic panic panic.
i have also suffered with flashbacks and nightmares
its truely fucking horrible
well when i went for my follow up at the hospital i was a total state, i could not stop crying hysterically, all the way though the examinations. i fouind it worse than the birth tbh.
so i really couldn't fancy going back to see the consultant though my own making about the scar pain, ive reserched it a bit and i don't think theres anything they can do about it anyway, i really wouldnt want another op.

sex life wise, im still to scared to even be touched down there let alone have sex,
this is 11 months on
tbh and im hesitant to post this as i don't want to make any one else feel worse, but purely from my own pov i feel that i will never be the same again.[although take heart as many other mn posters have said you do get over it eventally] its just how i personally feel

lso i found noone understood, think people just think youve had normal stiches, they do not seem to understand the seriousness of the situation, i was even told by my mother that i need to get things into perpective, when i told her the gp told me that he had never seen a case of a 4th degree tear in all his years as a gp, and she also told me that just the same thing happened to her, it didnt she just had stitches, and that id should be doing more around the house about 4 weeks post birth.
i found that quite difficult that noon understood what id been though.
although dh was good about it all.

milkgoddessmakesthefinestmilk Wed 14-May-08 09:54:38

cyee, did you realise you posted the other thread, in post natal not childbirth?

are you still in your hospital bed ?

Cyee Wed 14-May-08 10:52:02

Morning all,

Hello DMCT and hello again Milky.

I'm home now Milky - I made them discharge me on Friday, but still mainly in bed with the odd toddle around the house. Thanks for letting me know about the other post. I'll stick it up on childbirth.

DMCT I'm sorry you had a dreadful experience. Part of the reason for starting this thread is that I think this sort of experience happens to a lot of women, and I think we all probably know that talking about it/time/PALS/birth trauma stuff will help eventually, but I think it also helps to have access to people who have been/will go through the same things. I think it's that thing where sometimes I don't want to be constructive I just want to talk about what's happened and how I feel.

The other thing, is that traumas like these are reasonably common and I think partly seem like traumas because I for one (and I am one for reading EVERYTHING) didn't know this was even a possibility. I think it would be better if we all realised that yes childbirth is an amazing thing, but that it is a trauma, even if, like me, you walk out of hospital 6 hours later with not a stitch. My consultants have all said the same thing - that sooner or later every woman feels the impact of birth, unless they have been tremendously diligent with their pelvic floor exercises. You only have to look at the supermarket to see that there is as much space given to sanitary products as to incontinence products. So I'm a bit annoyed about this 'trauma' because if it was more talked about and known about it would still be bloody unpleasant but we probably wouldn't all feel so traumatised because that's as much about shock as anything.

Anyway - that's my rant over with.

I am feeling a lot better today, thank you and thank goodness.

Like you Milky, the idea of intimacy went out the window. I know most of it is psychological because we actually did the deed once, just before I realised there was a problem (I thought he'd broken me!!!!). Since then the idea of libido... well.. what's libido? Bless my DH, his tender nursing is mainly in the name of getting some action I think He has been a star but it must be sooo hard for him, as physically he hasn't changed.

DMCT - do you know what kind of follow up surgery you'll be having, and if you don't mind saying, what are your symptoms now? Mine were lovely... wind from my vagina and traces of stool in my discharge after I opened my bowels (oh I have developed a right vocab about this now). Do you know what kind of consultant you'll be seeing?

My tips are:
- Ask about why a specific consultant has been selected for you. I say this because the sort of op I had can be done by gynaes, urologists and colorectals. There's a fair bit of overlap. It might be good to understand what's being recommended for you and why. I didn't ask this question because I really liked my consultant and when I Googled him (stalker? me?) he was clearly a bit of an expert on this sort of obstetric injury (I'm in the NW, where are you?). They all do things different ways and there are lots of effective ways to address these problems. Sometimes referrals are just automatic, as in, childbirth-related=gynae, when actually there might be another/better options. It's important you have as much confidence in the people treating you as possible. You deserve good treatment!
- I took my sis in law to my second appointment, more as a second pair of ears as anything, as even though normally i'm quite good in these situations, I just found myself nodding and not asking any questions. So find someone who can be a agood advocate who makes sure you get any questions answered
- Has physio been recommended to you? Physio didn't sort me out but psychologically it was really helpful and basically she helped me work on my pelvic floors which is good anyway and especially good if you're going to have surgery. So I'd ask about that, if you haven't been referred already.
- Ask about future babies (if you're contemplating having any). One of my worst moments was when I was told that if he repaired me now, I'd have to have planned c sections in future. Now, before I had my LO I'd have loved a c section, but I was traumatised because I didn't see this coming and I hated the fact that my choices had been taken away from me.

In terms of the surgery experience, I had a general and therefore don't know what went on. The nurses and hospital were amazing. I have to say though that I am glad that I am 10 months post-birth. Milky, I don't know how you and DMCT coped with newborns and all this. It has been much easier for me to deal with this with a baby in nursery and family around.

Now - that's a bit of an essay!

Hope you're both ok today...


milkgoddessmakesthefinestmilk Wed 14-May-08 12:20:10

hi c, glad to hear your feeling better today and your home,
can i ust stress to really take it as easy as you can smile

may i ask you about the wind from the vagina? i find when i pass wind from the bottom, it comes up though my vagina
havnt been offered physio and wouldnt want it either, if it involves any kind of touching down there

i agree that it should be talked about more, and i share your shock about not even realising these kind of injuries are possible, i had NO idea this was even possible.

c, do you find thoses around you understand whats happened to you? my mum certainly didnt and i find that quite frustrating its as if she thinking im being a drama queen over it.

do you think you'll ever feel the same again, in time?
im hoping in time maybe over the years the scars [mental and physical] will fade and be less painful <> hopeful>

quickdrawmcgraw Wed 14-May-08 12:37:02

I also had no idea that this was possible either until I was told about my tear after ds was born.
with dd I had had a CS due to failure to advance.
with ds they told me during the delivery that he was going to be big so I got an epidural top up for the end of the long labour. Ds was born and weighed 10lbs 10oz.
Midwife came to me after I had been sewn up and said that although I had been given an episiotmy that I had torn to my back passage and had some rectal muscle damage.
Recovery was extremely painful plus I was worried that I wouldn't have a full recovery. I went back to have my check up 4 months later and thankfully because I had been very dilligent about my excercises I had made a full recoverly. As a neighbour said 'the interior of my posterior was in no way inferior' wink

ds is almost 6 now and through the years I have all but forgotten about it. I still find now though that my sphincter muscle wouldn't be 100% if I'm out jogging. Not that I would soil myself but I would have to find a toilet pretty bloody quickly. As a result I don't run marathons but I think that's the only change in my life now.

milkgoddessmakesthefinestmilk Wed 14-May-08 12:41:19

also wrt having more children, ive only ever wanted one or two children,so purely on that basis im unsure. so even if i hadnt of had the complications aftr the birth im not sure i want anymore iykwim, i had a rough pregnancy too and the 4th degree teat would put me off having more children tbh

but when ive thought about it and if i had of had say a hystretomy because i also had a pph, and then my option to choose to have mor children or not had of been taken away from me, i would have felt gutted
so prhaps a part of me does want another baby

when people ask me when the next one is, and i say im not sure there will be another, they seem v v shocked and ask me if i can have anymore and if dd is a nightmare
luckily for us dd is an angel baby and the joy of our lives.
i think people just find it shocking that someone maybe choose to only have one child.
but before i had dd i knew i wanted a baby, 100% but i just don't feel that way about having another.
ive also read on here that some people do not feel that there family is complete until they have had the 2nd 3rd or 4th baby, but again i simply do not feel that way.
im wondering if i'll feel more broody when dd is older perhaps going to school etc?

although i know i would feel much more scared 2nd time around, in a well you know what your letting yourself in for.
i really do not know if i would try a vb or a cs 2nd time round, thy way i see it is

1. vb maybe get lucky and not have a 3/4th degree tear again.
2. cs will not have a 3/4th degree tear

definltley feel it would be much much eaier to have a cs than have another 4th degree tear as 11 months on im still not over the 4th degree tear, but if you chance it and i do feel like it would be a case of chancing it, and have a vb and get away witg it that would be grat, also the risk of double incontince is perhaps too much of a risk...
its really a tough one

c, do you plan on having anymore children? if so what do you think you'll go for a vb or cs?

milkgoddessmakesthefinestmilk Wed 14-May-08 12:53:49

hi quick draw, yes i have th sam thing, that i feel whni get the urge to go to the toilet i have to go straight away. no hanging about!

also qiuick draw, having experienced both vb and bad tear and cs what would you go for if you had a 3rd dc?

have a shame that you had been sewn up the they realised, may i ask how is your sex life? did it effect you at all?

quickdrawmcgraw Wed 14-May-08 13:03:46

When I went back for my check up I asked about a scheduled CS next time and they said that that's what they would recommened. Something about the strain on the scar being too great and a strong likelihood of it happening again.

I'm not planning another but if it ever happened I would definitely go for a CS. My sex life wasn't really affected in terms of pleasure but I certainly found that that I was expelling a lot of air (fanny farts) in certain positions for at least 4 years after the birth. I'm not sure if this was as a result of the tear but it was offputting. That's much improved mow.

milkgoddessmakesthefinestmilk Wed 14-May-08 13:11:29

thanks you for answeing that quickdraw, its good to hear the views of someone thats ben though both cases.
its also great to hear that 6 years on youve almost forgotton about it all.

Cyee Wed 14-May-08 13:48:24

Hi quickdraw,

It's really good to hear that your life (and sex life) is much improved. I absolutely love that: 'the interior of my posterior was in no way inferior'! Fantastic!

On the wind front, Milky, - my wind was actually coming out of my vagina because there was a tiny hole between the two. What you describe sounds like a weakness in the sphincter, which I also had - this also causes the urgent need to go to the loo, because the 'ring' isn't tight enough.

I think that physio might really be worth looking into. My physio would certainly take into account your desire not to be touched. In my case the first session was just to talk through pelvic floor exercises, then she did do an exam. Interestingly she was a) the most gentle person who examined me and b) the only one who could actually feel that there may have been a little hole. My GP and gynae were pretty rough. The other thing we did was use a biofeedback tool, this basically involves inserting a probe into your vag (I did this myself once she showed me... with LOTS of lube!) and this measures the strength of your pelvic floor, so you really get a sense of progress. I'm also slightly competitive (but useless at remembering to do my exercises most of the time) so this meant I had to do them and couldn't cheat.

In terms of future babies. I think I would like more, though not for a while. If I do it, I will definitely have a planned c-section. My consultant might let me try vb, but the idea of going rhrough all that again.. well.. no way. Also, the girls from my antenatal that had c-sections seemed to recover more quickly than those who had regular stitches. I just have irrational feelings that I would have liked to have had my babies the same way which I know sounds stupid.

I totally know what you mean about people not understanding. At the beginning I was really shy about talking about it but people kept asking me questions so now I am a TMI nightmare! My mum passed away a few years ago and my dad now knows more about my arse than I ever thought possible. However that has really helped me because they do understand and it has helped de-stigmatise it for me. I really do see it as just another orifice now But no one around me showed any recognition when I talked about what was happening. In addition when you Google 'fistula' it says this has been eradicated in the western world and only happens in developing countries (?!). So with all this, I felt very much alone and only really became more outspoken about it so people wouldn't think I was being a drama queen. I really feel for you.

The thing I am starting to get really passionate about is quality of life. I have been meeting women in their 50s at my appointments who are now seeking help for problems relating to childbirth decades ago. Some have been living with faecal incontinence all that time and done nothing because they thought they were freaks and because of the stigma. I am (well was!!) a bit funny about my bum, and the worst part of this whole thing for me was having to have it examined and then have tests done on it. Both were MUCH better than I ever thought and while I wouldn't be volunteering to do them again, I'd have done anything to get this sorted. However time may be a good healer, and my consultant seemed to suggest that there was no timeframe in which it had to be dealt with.

I also have a controversial (hopefully that rather than pervy!!) thought on the sex life front. Years ago I bought a cheapo vibrator, more for a laugh than anything else. However it has really helped me with the intimacy stuff through all this. Away from my DH I messed around to see if everything was 'working' and it was a huge relief and lift to realise that it was... and I have to say maybe a little better sensation-wise. This did not result in me jumping into bed with DH (bless him) but it has helped me remember that I am a woman and that side of me hasn't died, even though I sometimes have felt it has. So while this is obviously not for everyone, I can recommend as a way to maybe get back to business in a gentle way, on your own blush

Sending you all positive vibes

janey73 Wed 14-May-08 13:50:04

Hello everyone, have been reading this thread with interest and can relate to everything thats been written. I had a 3rd degree tear 2 years ago and it was the worst experience of my life. Had a 'normal' labour which wasnt that painful and only had gas and air. I remember giving birth to my daughter and feeling so proud that I'd done it. 5 mins later the room was full of people telling me I needed to go to theatre because I had 'a deep cut' and I was being asked to sign consent forms which listed incontinence as a possible side effect of the surgery. I remember lying in the operating theatre for the 3 hrs it took them to sew me up and everyone ignoring me, as if I didnt exist only my body. At one point they called the consultant as I wouldnt stop bleeding, the consultant stood in the doorway shouting out instructions to the surgeon- he couldnt even be bothered to scrub up and come into the theatre. I remember lying in the postnatal ward in absolute agony not being able to move let alone walk surrounded by what I perceived as 'lucky' women who'd had their babies without having their backsides ripped open. Even to this day I ask myself everyday Why me? It took me over a year to heal, had infection after infection but the worst thing was no-one cared. Saw gp's, consultants none of who seemed to give a damn about the pain I was in and didnt want to do anything. I wasnt offered any physiotherapy or scans to check on healing but left to get on with it. 2 years later I have really bad scar tissue round the bottom area. Plucked up the courage to see my gp last week and the whole experience was traumatic. She didnt speak a word of english and didnt understand what I was saying at all! She said the only thing she could do is refer me (she didnt know what type of doctor to refer me to..) and didnt know how long it would take to get an appointment. Everyday the scar tissue itches and pulls and its hard to lead a normal life. I feel like others on here, I dont think I'm ever going to get back to normal and it makes me so sad.

Anyway, thanks for reading. It certainly helps to rant and to talk to people who know what I've been through. Hope this thread keeps going!

Nosnik Wed 14-May-08 13:55:34

I know this is nosy but I don't actually know exactly what you are talking about. Obviously I can get the gist of it but could anyone bear to tell me exactly what 3rd/4th degree tears are? and what is a fistula?

Nosnik Wed 14-May-08 14:01:16

My interest is because I had a big baby and have been told my next will be, I had a tear and 3 stitches, does that mean I could tear worse next time?

milkgoddessmakesthefinestmilk Wed 14-May-08 14:04:56

hi janey, youe experience sounds like mine, in that it sound s like you thought thats it ive done it after giving birth to your dd, then all of a suddne its panic stations
i wish i could give you all a hug, and im not the huggying type!
janey may i ask you if you feel upto sex? or if you plan to have more children and if you did you you go for a vb os?
sounds like they trated you like a peice of meat, the bastards. i made a formal complaint about how i was treated.

c, thanks for the info about the physios but i really really cannot face the thought of any touching or certainly no probes,

im just clining onto the hope that one day thte scars will fade, i had a scar running down into my leg too, and this one rubs on my clothes.
how long do scars take to heal?

one other thing i think i fould difficult esp in the early days, is people saying oh well it could of been worse, well yes thats true in nearly every situation it can always be worse, i mean you could say to someone that has lost both legs, oh well at least you did 'nt lose your arms.
i found people that said that sort of thing quite hurtful and dissmissive, although i ralise they whre probably only trying to help and its probably all they could think of to say, but i still found it v dissmissive

Cyee Wed 14-May-08 14:10:02

Hi Janey73 and Nosnik,

Janey73 - so sorry you've had that experience and I hope your GP or a consultant can help. Rougly, where are you based? As in my last post, my consultant was clear that there wasn't a tight timeframe for getting this sorted, so it might not be too late to get more help if you'd like it. I'd hope you don't have to live with the discomfort you describe.

Nosnik - happy to explain. I can't do the 3rd/4th deg tears bit as don't know exactly, other than I think the 'degree' refers to how deep the tear is, first degree is just a surface tear, 4th degree usually goes through muscle I think... Hopefully someone else can explain better.

You can get fistulas in other parts of your body but basically it's a 'communication' between two parts of the body that aren't usually connected. In my case it was vagina-anus, but it can also be bladder etc. It is essentially a weakness or breakdown in tissue that is a constant hole that doesn't/can't heal on its own. In my situation it meant that wind and small amounts of stool could come through, if the fistula is large, then it can mean more material comes through. Fistulas are generally not just 'stitched up' because the tissue is weak anyway and the repair may not hold. So I've read of 'patches' being used, or in my case the fistula was excised and the remaining tissue was overlapped and stitched back up.

Hope this helps explain.

I hope this thread keeps going too. It is enormously comforting (in a very odd way) to know you're not alone and to 'be' with people who can share your experience and who aren't always encouraging you to get over it.

I want to get over it and I don't want this to define who I am, however it's a massive part of my life and it's great to be able to share it with you all. Thanks for coming on

Nosnik Wed 14-May-08 14:17:45

Well I'll come and bump it every now and then for you XX

All the best and thanks for the explanation.

MrsTittleMouse Wed 14-May-08 14:18:41

Hi nosnik - you're probably better offer posting a new thread on the Childbirth topic. But so you know the degrees of tear are:-
1st - skin only
2nd - skin and muscle
3rd - skin and muscle up to the ring of muscle around the anus
4th - the same as 3rd, but also tearing of that ring of muscle.

Three stitches is actually not that many, so your tear won't have been too bad in the general scheme of things. And generally speaking because you've already stretched your bits during the first birth, your second should be easier.

Cyee Wed 14-May-08 14:20:56

Hi Nosnik,

I don't think anyone can predict future outcomes accurately, but definitely worth speaking to your consultant or GP about it, as tears are sometimes par for the course, but if your future continence etc. could be compromised then I'd think they'd want to keep an eye on any future pregnancies to assess size etc. Good luck.

Janey/Milky - sounds like you both had a total nightmare. I am also not the hugging type (!) but a group hug could go down well here I think. My (female) gynae was also dismissive and my (female) GP acted like I was a) mad and b) filthy. I know this isn't common, but it's not exactly a revelation. While in theatre waiting for my op, I read through my notes and my referral from the gynae pretty much told my colorectal consultant my diagnosis, which was... you guessed it.. wrong. There's clearly a lot of confusion and possibly professional egos involved in this, because it is a cross-functional situation involving gynaes and others.

It's awful that you are hesitant about seeking treatment because of how badly you were treated initially. The idea that we could live with unsatisfactory symptoms because of this makes me so upset and so bloody angry - for f*cks sake how can this be happening? It's like the last bastion of sexism. Childbirth? Trauma? Suck it up. It gets me so mad because it's not those consultants that are on boards like this... it's us... us having to live with it and try to support eachother through it.

I know physio and other exams may sound hideous right now, but maybe in the future they could be an option. I really hope they will.

On a more hippy front, I have heard massage with BioOil or Sweet almond oil is amazing for scar tissue and I know from my best friend who had bad scarring (elsewhere on her body) after a car crash that there are compression therapies and other things they can do with scar tissue. My consultant said I will be aware of the scar tissue (no kidding, my perinieum currently looks like top of cornish pasty!) but that with 'use' it will soften...

Non hugging hugs to you all...

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