Please help!! Desperate for Consultant Colorectal / Gynaecologist recommendations for Rectocele

[NewMummySarah]

Hi everyone, i’m a 35 yo first time Mum feeling very low right now and desperately hoping for some advice from any fellow mums who’ve had a rectocele / rectocele repair.

I’m 14 months postpartum with my first baby, and used to lead a very active life (running, rock climbing, dancing, yoga & Pilates) so was devastated to find out that the heaviness & general feeling that everything was still too ‘loose’ down there is a combination of external hemorrhoids + rectocele (possibly with beginning stages of uterine prolapse too) 😭

As the NHS is totally overwhelmed due to coronavirus my private healthcare has referred me straight to a colorectal specialist as a starting point - so I’m hoping there are others who have been through this with good results and can recommend a good consultant? (either colorectal or gynaecologist, as I will probably need to see both)...

I feel too young to have my health, identity & all my hobbies taken away from me :( I’m just feeling really lost right now as I can’t do any of the things I love and even picking up my daughter feels like it’s doing me harm... I would love nothing more than to run around after her but can’t see that in my future now :(

I had a normal delivery (vaginal water birth) but did have to have manual removal of the placenta (during which the midwife & surgeon both attempted to yank it out - absolutely excruciating - with no success)...

Has anyone here had a successful rectocele repair? Anyone experienced rectocele with a side of hemorrhoids ...how did this affect your treatment? And has anyone experienced this and been able to reclaim their active life somehow (through surgery or rehabilitation)?

I’d really appreciate any advice or support as I don’t know where else to turn, thanks xx

Sorry to hear that you're going through this, @NewMummySarah - hopefully someone will be along soon to offer advice.

Take care.

Hi. Sorry to hear you are going though this. I was diagnosed with a rectocele almost 2 1/2 years after having my ds. It was a awful delivery with forceps. I was referred to physio which I was sceptical about, but it has made a huge difference. I was told if you can do everything to avoid surgery then you should, as surgery isn't perfect and might cause other issues. My gp felt surgery was essential, but my physio (specialist women's health one) felt I had repaired a huge amount of damage. I have been seeing her for around 7 months. I was referred to an obstetrician and had a rectal ultrasound to determine whether those muscles had torn. It showed damage but no full tear so physio should keep working. I'm afraid I have no hemorrhoid experience so can't say how that may change things. A crucial thing is your toilet position. I was recommended to get a toddler a step (for reaching sink in bathroom) and putting my feet on it when I go to the toilet. That puts your muscles in a better position. I was also told never to strain. Without being too disgusting I suggest you look at the Bristol stool chart (online) and try and make sure you are not at the top or bottom (constipated or loose) as this will help. I was massively down when I was diagnosed and did not believe physio would do anything, but it has transformed my life.
I am sure someone more knowledgeable will be along soon, but feel free to ask any questions you want. I really hope all improves for you soon.

Thank you both for your comments 💗 StarDanced, if you don’t mind me asking we’re you told what ‘grade’ yours was?
Has your physio allowed you to get back to doing any ‘normal’ exercise (but which I just mean not just pelvic floor postnatal style exercises)? I don’t want to be smashing it in the gym or anything - but at the moment even just running for a bus feels awful 🙈... I’ll definitely look for one of those stools as sometimes I often feel a ‘heaviness’ for a day or so before a bowel movement - and is always tempting to strain a little to move things along rather than wait... which I know is a big no no! Were you told of anything else that could help / anything to avoid it getting worse (especially if more kids are in the plan)? I’m now terrified of the damage a second pregnancy will do! I’ve seen a lot online about pessaries, oestrogen cream and the kegal8 eclectic toner ...but not sure whether any of this will really help 🤔
Thanks for your help x

An internal assessment of pelvic floor muscles by the physio said it was a 2- weak (with 0 being the worst and 5 being the best) and after 6 months of physio it had changed to a 4. When I was first diagnosed I had heaviness, pain most days and couple of episodes of rectal bleeding (being a mum is so glam!). Now the pain is gone and so has the heaviness.
I saw a consultant obstetrician as my dh and I were debating a second child and she did a full exam said there was no issue getting pregnant. Pregnancy will make symptoms worse but no worse than a lot of pregnant women face so no issue there. I was told I cannot have a vaginal delivery as it would be far too risky. I have a letter written by her stating the need for a c-section. I was seen through the nhs and my gp was really good at referring me to the consultant as I was wanting to decide on another child. Might be worth looking into this when the global situation improves.
As for helping, I haven't read about or tried any of the things you mentioned. It is a bit too much information, but if you push your fingers onto your perineum (externally) when trying to poo that can really help and prevent you straining. I was also told to stop lifting things, as heavy lifting can make it worse. Rather difficult when you have a little one I know. I started on a schedule of 5 quick pelvic floor clenched 3x a day and 5 long ones (30second hold) 3x a day. The long ones were impossible start with but hold for a long as you can before you feel them going- e.g start with 5 seconds for a week, then try 10 seconds. A good women's health physio should be able to sort you with a plan.

Thank you so much for your advice StarDanced 🙏🏻 I’m happy to hear that you have managed such improvement as it does give me hope! I’d like to have a second child but am quite worried at the prospect of making all this worse ...and you are so right about motherhood, people tell you but you really don’t believe most of it until you’re the lucky one it happens to
I really appreciate the info on your regime as I think it will be a while until I can see a consultant given what’s going on - so I’ll give your technique a go and see how i get on. Thanks again, it really helps to know things can be improved x

Hello! First of all I’m so sorry to hear of another woman to being going through this. It’s such a tough time ....I’ve been there!
Was diagnosed with bladder and bowel prolapse after a long and difficult labour. I was 33 and loved running , working out , and generally just being active. I was absolutely distraught with the diagnoses. I went to lots of different doctors /physios /uro Gyne, colorectal. I got lots of varying suggestions but ultimately I learned That surgery is not the first port of call with pelvic floor issues. There are things you can do to help.

First of all find a good women’s health physio...not just someone who tells you to do pelvic floor exercises and avoid lifting. That’s not helpful when your goal is to return to exercise. You can do so much with a prolapse but just need to modify
Look up “pop uplift”on Instagram -they have lots of good info. Also have a look on Instagram there are so so many women that are now speaking out about this issue and posting prolapse and pelvic floor related content which is really helpful . DM me if you want some specific names

Secondly , as stardancer said - look at toilet habits. Figure out what keeps you regular.Get a step or squatty potty, drink loads of water. Don’t strain and don’t get constipated. It’s hard I know ! Also supporting Perineum

Look after your mental health. This was a big thing for me, I was obsessed and just wanted to “fix” myself. I blamed myself for what happened. But accepting that some things are changed forever (not gone, or never to be done again but just changed and different to before) when you become a mother.

I too was so worried about another baby. But here I am nearly 4 years after my first birth and I have a 16 month old too! Had a c section this time and no damage to pelvic floor from pregnancy. I still have prolapse which I’m not thrilled about believe me, but I’m happy again, which I didn’t think was possible.

Time is the biggest healer: I was where you were 14 months post baby number one. There’s so much hope xx

Hi Immaback, thank you so much for your reply - I have just had a look at POPup on Instagram and the posts I’ve looked at so far are amazing, it’s really good to hear them speaking in a way that reflects how I feel!
It’s also nice to hear from a fellow young, active person - as even my NHS physio said she couldn’t answer many of my questions since it was rare for her to see any new mums in our area who “ran” or “had active hobbies” they wanted to get back to. I really felt like my interests, goals and identity suddenly don’t matter anymore - and I have to somehow re-adjust all of that overnight...
I know that everyone’s story is different, but what kind of exercises are you comfortable doing these days? (If you have any time with a 16 month old!). I don’t suppose you are in/around London and have any PT recommendations do you? ...and (no need to answer if you’d rather not) but do you mind me asking whether you requested your c-sec or if it required for some other reason? Even if things never get much better it’s just nice to hear from ladies who understand what it feels like to come to terms with it all x