Rectocele repair: is it necessary?

[StiffyByng]

Just after some advice really. I had my daughter over a year ago and from the start things felt 'different'. I had problems occasionally emptying my bowels and could feel a bulge into my vagina. I kept meaning to go to the GP about it and finally got round to it a few weeks ago. She referred me to the urogynae team at King's, saying she thought I had a slight rectal prolapse. I was seen quickly by Professor Linda Cardozo. I was rather astonished to be told by her that I had a moderate to severe rectocele and needed surgery, although not until I've had any other children. She also told me I had very thin and dry skin and was surprised to hear that sex wasn't painful for me, and that I have no other prolapses. The thing is I really am not particularly inconvenienced by this whole thing and don't really see that it can be as bad as is being made out - surely I would be experiencing more issues? Can I ask those who've had similar problems what symptoms they had? The operation sounds rather scary and I want to be sure about the need for it. Is having more kids likely to make it all worse? I assume it will! Is it permissible to ask for a second opinion within the NHS?

Hi. Poor you. Can't offer specific experience re rectocele repair but I have a mild anterior prolapse and have had a sling put in but not the mesh repair. The sling procedure, which was day surgery and is a minor op in the grand scheme, was not a small thing as they said no lifting for 6 weeks, no more pregnancies after, etc etc. I understand that the full mesh repair for anterior prolapse (bladder) or rectocele is a much more significant operation with longer recovery time (no lifting toddler etc - I waited till my youngest no longer needed to be lifted before I had my op), definitely must be done after last pregancy, no serious lifting ever again (as if repair is damaged it is very hard to repair a repair ) etc. For these reasons I would definitely not consider the mesh repair until it was absolutely necessary. My friend is in same boat as you but sounds much worse and she has held off on the op so far as she has ponies and needs to do lots of lifting of feed etc which the op would prevent and she has been fitted with some sort of thing like a donut which holds everything in place (stays in for 6 momths at a time) and this is working well. Definitely don't rush into anything and I would hold off for now and then get a 2nd opinion if things worsen.
Good luck.

Hi there, I had a rectocele repair at Kings,with linda Cardozo in November.
I first noticed weak pelvic floor after my first child was born,after the 3rd there were more problems and a noticable rectocele but after no 4 things were much worse andI had a large cystocele and minor uterus prolapse too. I waited untill dc4 started reception and the risks were outwayed by the benifits.I had hardly any feeling during sex and I was unable to poo without helping with my hand. The op repaired the prolapses and I had a vaginal hysterectomy at the same time.I was 38. It was major surgery but I was ready for it and it was SO worth it.I was having daily pain and I'm so glad its gone.
My advice would be, forget about it until you've finished your family or it's impossible to live with.But it will probably get worse.
Oh, and by the way, Ms Cardozo has a terrible bedside manner but I travelled 200 miles for her to operate on me.She is an expert, top of her field.
hth.

That sounds spot on advice 14k.

Thank you. I have to say, I noticed the bedside manner was a bit lacking. She was a bit more, um, straightforward than I'd have liked, but not awful. She told me pretty emphatically I need to lose weight, which is true, and told me to stop breastfeeding straight away, which I have to say I've ignored.

I'd like three kids so I'll brace myself for what might happen. I have had problems with my bowels all my life so maybe it seems less annoying than it might for others who have had no issues at all before having kids.

It was because I have very dry and thin skin (apparently) in my vagina (when I looked it up, it's called senile vaginitis - lovely!) - she thought I should stop breastfeeding to bring my oestrogen levels up. She obviously couldn't understand why I wanted to feed my 13 month old. I have compromised by reducing the feeds but really didn't want to stop. I'm yet to have a period so obviously I'm not firing on all hormone cylinders.

I'm 35 so need to fit in (ideally) two more kids before I hit menopause, but as my mother had her second child at 46 I'm hoping genes are on my side.

Just to add, I had a gynae physio appointment today with a really lovely woman. She felt that my prolapse was far less significant than the others had found and suggested that they had seen me later in the day. She told me my muscle strength is 5 out of 5 and I need to work on my endurance but was basically very positive and encouraging. Hurray.

Hello

so pleased to have found some info on Linda Cardozo. I am in a real quandry and greatly appreciate any advice.

How did you know she was top of her field.

I have had a uterus resuspension with mesh but now have a largeish bladder prolapse and i have been told i need an anterior vaginal repair with mesh and possible tvt tape by my surgeon Dr Fayyad who is lovely but I keep hearing terrible things about mesh.

So am hoping to go for a second opinion with Linda Cardozo. Any comments or info on her would be greatly appreciated.

Many thanks

I saw Linda Cardozo about 10 years ago re prolapse and retocele .

I didn't persue it then as I found her unhelpful ... too practical and concentrating on the physical for sensitive little me .
She was keen to only do it after a hysterectomy as if ( if I understood/remember correctly ) they do the repair and then have do the hysterectomy it can mess up the repair .

I eventually had a TVT and and repair with John Bidmead at Kings . Who has lovely bedside manners .

I think you might find that the op won't necessarily be carried out by the consultant .Isn't it often just one of their team ?

Thanks for your reply ginger roots, this forum is soo helpful. I'm so concerned about mesh but really don't thinkk I can face anyone insensitive!

Thanks again.

daisy - I really don't know if this is relevant but Cardazo was suggesting a colposuspension for me rather than TVT and maybe you'd be happier with that ?

But it was 10 years ago ,so possibly she wouldn't now .

But thought I'd mention it .

Why are you worried about the tape ?

I was a bit ,felt it was a " foreign body " ,but it's been fine .

Why don't you ask on this thread
www.mumsnet.com/Talk/general_health/1514278-Any-old-prolapse-Uterus-womb-prolapse-rectocele-cystocele-enterocele-urethrocele-incontinence-pelvic-floor-anterior-and-posterior-repair-TVT-etc-part-5

thanks I will check out the other thread, I'm not so worried about the tape, more the transvaginal mesh, which seems to be linked to so many horror stories. So pleased your repair etc has worked out well.