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

[Jacksmania]

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.

All welcome.

Oh, Caffe1ine, that's terrible :o - I am just cringing on your behalf!!!
It's probably no comfort at all that the nurse probably gave no thought to it at all, since she sees things like that all the time. Oh, I would have wanted to sink through the floor. Poor you. Have some and .

Ok, babynelly, I've given some thought to your post, and first, I think if I were you, for the 6 week check, I'd ask for a slightly longer appointment so that you're not feeling rushed and uncomfortable.
Then I'd ask the GP to do a very thorough exam, and stress that you were told by a midwife that you might be developing a bladder prolapse. If you're having any symptoms (urge incontinence or stress incontinence) make sure you mention those.
Also, would it help if you wrote down, in a bulleted list, what you've posted here? Then, if you get nervous, just hand the list to the GP.
Could you take someone with you? Someone who bolsters your confidence?
And finally, if the GP tries to fob you off, could you say very firmly, "I'm sorry, but this does not feel at all normal to me, and it certainly feels different and worse than when I had my daughter, I'm afraid I really would like to insist on a referral." Repeat as necessary.

Does that help?

Hi, I've not been on here in ages (I had nothing new to report, and I couldn't cope with seeing how so many were getting repairs, and I was still struggling to get even a diagnosis), but I thought I'd come back and say that I now have been diagnosed (yesterday) with a moderate (not small) rectocele, and a cystocele (I had an examination under general anaesthetic). However, it still seems that they are not planning to repair???, and will see me in three months (to discuss the situation), despite the physiotherapist saying my muscles work well (4 out of 5 score) and she would recommend repair as the only way forward! I just want to sit and cry, and wondered whether my personal bits are supposed to completely descend (to the point of being visible at all times) before any kind of repair might be considered. How much is it to have this all hoisted back up in a private (presumably very costly) clinic? I am sick of being in pain, having to manually evacuate, and not being able to guarantee that one bit, or the other, won't leak if/when I get the chance to have sex again (my H left me in February, after making me spend most of our 9 yr marriage celibate). I've never heard of a man being refused a hernia repair, and I see news of girls getting bigger boobs because their small ones upset them, so why is this considered non-essential?

Oh Nanna, I'm sorry to hear you're not getting the help you need. That's just bloody terrible :(
I'm so sorry to hear about your ex, and just everything. I'm not in the UK, so I don't know what the cost would be. I'll let the FB group know about your post and your questions, maybe on of them will be able to help. PM me if you'd like to join us, it's a secret group, so content is not searchable on the web.
Same goes for anyone on here, if you'd like to join the FB group do please PM me.
((((((((HUGS))))))))) Nanna.

Nanna, my gp warned me that with mine they might hesitate to repair because of my age, but assuming as you are "nanna" they cant be using that excuse with you! Don't know if you can write to pals with queries like this, might be worth a shot?

And babynelly its probably worth you sending a complaint over to them too, if your notes werent followed and you didnt get to see a consultant thats def worth a complaint :)

My new gyn appt has been moved back again to the end of oct! If i'm lucky i may see her by the end of the year at the rate i'm going!!

Thanks Beyondthelimits, I will try to contact them, and see if anything can be done. I'm so down about it all at present.

Feeling positive today. Like you cardamonginger the NeuroTrac seems to be helping. Either that or stopping breast feeding. Anyways, was at physio earlier and they declare am now getting a slight lift with my contractions (wasn't before) & that my strength has gone up one on the scale. And am actually getting a properly visible contraction with the stim unit so here's hoping.. Hope you're all doing well?

Hi can I join you?
I am currently suffering again after approx ten years of (relative) normality and feel really down.

After 3 kids in two years (!) and a 4th large baby 3 years afterwards I had a prolapse. rectcele and cystocele and had a hysterectomy (but no repair)at 35. Reasonably good shape after tho bowels don't work without suppositories..

However this year I took up running.. and am working in a class (special needs..physical disabilities) which entail a fair bit of lifting.. and suddenly I'm in aching pain.. feels like my insides are dropping into my vagina..hurts to stand for long, just hurts really:(

It never occurred to me that running would be bad for my pelvic floor..I don't wet myself (and appreciate how lucky I am there) if anything I have trouble peeing...and pooing.

I'm currently lying down a LOT when not at work, sitting down whenever I can and am not lifting any children..but it seems the damage is back in whatever new form it has taken.

I saw my gp today who didn't even do an internal, but told me to 'rest' ha!
I'm not sure what to do next except to lie still and hope it improves a bit.. taken tons of painkillers for the last few weeks to no avail:(

Any suggestions gratefully received:/

Oh Medusa - I'm so sorry you're having troubles. That dragging aching feeling - how well I know it, I'm still awaiting hysterectomy and repair for a prolapse.
I don't know if we're the best thread for you though - have you tried posting on the "any old prolapse" thread? Although I myself suffer from a prolapse, most of us have problems with tears and scar tissue and that sort of thing.

In terms of concrete advice, sorry, but "rest" isn't going to cut it . If your GP can't do an exam for cysticoele/rectocoele, he needs to refer you. Also try referral to pelvic floor physio.
Sorry, DS has just woken up (morning here), will check back later. :)

Hello everyone,

Have lurked here for months now but have been too shy to post

My DD, first child, was born 8.5 months ago in February this year. I had a fast labour (only 6 hrs!) and pushed for 25 minutes but ended up with a 3c tear which is almost a 4th degree tear. She was only 6lb 3oz so no one could really explain why I tore so badly. I was stitched immediately but the doc said it was the worst tear she'd seen in about 6/7 years!!

Now 8.5 months later and I've been having intensive physio for almost 5 months, which has helped some. But I'm still suffering from bowel urgency and poor control over wind!!!! The urgency is semi ok, I know I've got 5-10 mins max to get to the loo but I'm nervous when I go out. The wind problem is the worst! I can't control it at all if I'm standing up or walking and it makes me incredibly anxious in social situations. I'm a secondary school teacher and am petrified about returning to work with this issue.

I've already seen a gynae and colorectal surgeon. The colorectal guy did an ultrasound and said the sphincters were thin, but surgery wouldn't help. He said collagen injections may improve the situation somewhat but he wouldn't do that til I'd finished having kids (I want one, maybe two more).

So my Q is, have any of you had these symptoms and found they'd eased over time?? The colorectal dr said it may still improve with time and further physio but he said to never expect it to get back to what it was pre baby, but he can't say how much better it'll get.

Sorry if it sounds like I'm whinging, I'm only 26 and it's really knocked my confidence and lead to bad PND which I'm just starting to get treatment for. None of my other mummy friends can relate at all and I feel so alone and broken!!

Hi Neptuna (love your name ).
Welcome to the thread - sorry you had to find us though!

I had similar tearing to you, although my labour was quite different, and I also had double incontinence, which eased up over time, as well as difficulty containing wind.

From your post, I would say you have every reason to hope it will get better with time. It's 5 1/2 years since DS's birth and I can hold in wind, unless I'm not paying attention and it sneaks out, or unless there's a lot. I no longer have urinary incontinence, unless I've just waited too long, then it's deep breathing and clenching while I yank my pants down. Poo can be a different story, ok if solid but occasionally a near-miss if very soft (sorry TMI ). It's all been like this for several years now.
I would say I had all the improvement I got by the time DS turned 3.

It's lonely when you've been shredded by a birth and no one else in RL can relate :)
Come back and talk to us. The thread moves slowly but I, and I think some of the other regulars, are always keeping an eye on it.

Hi Neptuna

I really understand how you feel. There's so much more to recover from than most people. Its great you are getting treatment for PND, hopefully its counselling and not just anti-depressants.

Are you hypermobile at all? link here If you have a look at the beighton score you will see fairly quickly if you show any signs, a couple of us are hypermobile and this can lead to worse tearing during childbirth - which could explain why you tore.

Physically you sound similar to me, I had a 4th degree tear 2 years ago but a very different birth (long labour, 3 hours pushing and forceps). I struggled a lot with recovery but after about a year I got back to what I class as my new normal. I have urgency issues, and have had a few occasions of faecal incontinence - thankfully all at home so easy to sort out but really knocks my confidence. Keep doing your pelvic floor exercises as that is one of the only things you can do every day to help. Before falling pregnant I had managed to gain control most of the time of wind but currently I have no control over it, I find diet makes a big difference so maybe try eating less 'windy' food to see if that helps give you some control and confidence.

I am now currently 29 weeks pregnant with DC2 and so far I've not had any incontinence although I am having issues after I've had a poo where I cant seem to wipe clean for a number of hours later. I'm very self conscious about it though.

Hope this helps you feel a bit less alone.

hi neptuna! sorry you are here, but welcome . you're already had some great advice. i'm interested in what the gynae had to say, and whether the colorectal person specialises in injuries? what sort of scan did you have? anal manometry where you clench and release that measures sphincter strength? or was it an endoaal ultrasound where they look at the muscles? i'm wondering whether you have a gap in one of the pelvic floor muscles - this wouldn' t be visible externally, it shows up on ultrasound, and can also be detected through internal examination. if you do, that could be contributing to incontinence.

what physio are you getting? if things are very weak and have been very damaged, bog standard pfe's might not do it. i've been using an electronic stimulator to activate the muscles. sometimes you need an extra boost to get things firing again.

you might want to post on the 'any old prolapse' thread, also in general health. there' a poster there tr0ubled who is having specialist physio involving biofeedback to help with these issues. she's very lovely and very helpful .

Hi everyone

I hope it's ok to post. Cravingcake told me about this thread when I posted elsewhere. I'm just going to paste my original post below if that's alright. It took me long enough to write the first time, I feel like every time I write it it's like reliving it. I'm so relieved there are plenty of other women out there who have suffered after having their babies. It's just not talked about enough.

DD is 6 months old. Birth was very traumatic, 3 days of contractions, 12 hours in the pool before DD turned her head. Waters broken, meconium found so whisked to delivery suite, given epidural, another 10 hours of contractions, pushed for 2 hours and eventual ventouse. Just to top things off nicely I retained my placenta so was taken to theatre for a manual removal for which I was awake and lost a lot of blood so needed a transfusion.

I thought I had dealt with all of this and put it behind me. I was grateful to have my beautiful, healthy baby and was trying to enjoy my new family with DH. Problems started when I felt ready to resume 'marital duties', about 3 months in. It wasn't happening. Numerous abortive attempts, I put it down to being nervous and thought I'd just keep trying. I then happened to be due a smear so went along only for the nurse to say she couldn't perform it. Referred to GP who was brutal in her attempts but also couldn't perform it. Referred to consultant to be told there is a lot of scar tissue and I need to have surgery to recut everything and stitch it up again with the hope it will heal better next time round. I'm on the waiting list and have been for 6 weeks. Apparently I may not be seen until January. In the meantime I am left feeling extremely guilty about not being able to have a physical relationship with DH who is being very kind and patient but who, I'm sure, is feeling very neglected. I can't even kiss him at the moment, I feel too self conscious of my post-birth body and the fact that I can't have sex.

I am absolutely panicking about the surgery. I am lying awake at night for hours thinking about it. I have been told it will take place under GA but because I had a manual removal of the placenta I know what the whole scenario will look like and I can't bear to think about it. I felt so degraded and humiliated the first time around and I went into shock afterwards. I'm just so scared.

Add to that that I find myself constantly thinking about any future children we may have and whether their births will also be horrific.

I don't really know where I'm going with this. I just feel helpless and alone and it's starting to affect my relationship with DH and also with my DD. I look at her and think about how lucky I am to have her but then feel guilty that I'm having all these negative feelings.

Has anyone out there had this repair surgery? Can anyone offer me any reassurance or advice. The thought of going through the whole healing process again terrifies me. I don't know how I will cope, especially with DD to run after and with working 3 days a week from home too.

Sorry if this all sounds ridiculous. I just need to vent and if anyone can offer me any advice I'd be so grateful.

Hi Jacksmania cravingcake and cardamomginger, thank you so much for your replies! I had a little cry reading them all, knowing I'm not the only one out there who feels broken!!

I'm in Australia so about to go to bed (it's 10:30pm here) but will come back and reply tomorrow.

Thank you again for being so kind when so many doctors and specialists don't seem to care or understand xxx

Hi Saspi,

I'm sorry I missed your post yesterday!
You're definitely not along among us, several of us have had a re-cut and re-stitch, or even a perineal refashion. I had something like it done, not exactly that - it was called a wedge resection, inside my vagina, where the entire chunk of scar tissue that formed after DS's birth (forceps, 3rd/4th degree tear) was resected and I was re-stitched. That repair was entirely internal and was done when DS was a year old. I also had an external scar revision done when DS was 2 1/2, and that would be more like what you'll be needing. Neither was too bad. I have a very physical job, and could have gone back to it two weeks after the internal repair, but ended up taking three weeks off because I just didn't feel 100% yet. For the scar revision I think I was off for 10 days. Both were uncomfortable but not really painful, and I was very careful with pain management.

As for the emotional part - 6 months is such early days. What a shit time you've had, everyone on this thread will be able to empathize. :(
A traumatic birth just grips your mind and doesn't easily let go - I think because giving birth is one of the biggest things you'll ever do and so when it goes wrong, the trauma is equally big.

It will get better. 6 months in I was still a wreck and having therapy and trying to get a grip on myself. Be kind to yourself, and come and vent here.
((((((HUGS))))))

Ok back now

Saspi I haven't had further surgery to remove scar tissue (I had a 3rd, almost 4th degree tear) but I was given estrogen cream to use to help soften the scar tissue. I had to massage it into the perineal area (on the inside) for a few months and it made a big difference to the painful sex I was having. Is that something you could try? Although if there's too much scar tissue in the first place it might not be so effective. Perhaps you should consider telling your GP about your mental state too. I'm almost 9 months after a traumatic birth and have only just gone to see my GP about suspected PND and anxiety. I wish I'd gone earlier before I let it get so bad!

Oh and don't worry too much about future pregnancies, you can request ELCS after a traumatic birth I'm sure. Good luck!

Jacksmania thanks for the welcome! I'm glad to have found a place where I can ask Qs and be understood. So many of the Drs I've seen just don't seem to care. I'm glad to hear your problems eased with time, it gives me some hope I too will improve further. Can you remember when you noticed an improvement holding wind? The colorectal thought if it was going to get better it would have by now...I really hope he's wrong!

Also, I read that you were awaiting a hysterectomy. Have you had that done yet or are they still keeping you waiting?

cravingcake I'm seeing a psychologist as well as taking anti-Ds but have only just got the ball rolling as I had a bit of a meltdown recently!! I just can't seem to accept what's happened to me and the physical damage I've now got. I hope it all helps as I feel so awful all the time. I checked out that link but I can't do any of that stuff at all!! My tear was actually very unusual, it was a buttonhole tear where the perineum splits in little holes in the middle, rather than tearing from the top down. I had an episiotomy and the whole thing turned into a 3rd degree. Apart from pushing very hard on my back (the midwives were yelling at me to) I can't think of what else I did wrong...

I had a few poo accidents too in the early days and still don't like to be far from a toilet now, it's quite limiting but yes I do my exercises everyday in the hope it helps. Can you remember how many months PP you were before the wind control improved? I'm due to return to work in late January and, apart from moderating my diet like you said, don't know how I'll survive as a high school teacher with that problem!

Before I forget...congratulations on your pregnancy!!! How has your pelvic floor been holding up? I have heard of the after-poo leakage but if it's something you didn't have before hopefully it'll go once bub is born? Have you asked a doctor about it? I'm assuming youll be having an ELCS when the time comes?
Thank you for all your helpful comments (((hug)))

cardamomginger the gynae didn't say anything useful at all! Just referred me on to the colorectal and asked if I was having physio. The colorectal didn't have any particular expertise in injuries so I'm hoping for another opinion from one who does! He even told me to shove cotton wool in my bum crack to muffle the sound of the escaping gas...

He just did an endoanal ultrasound, not the mamometry. I'm interested in what you said about the torn internal muscles contributing to incontinence. Do you mean the sphincter muscles themselves or other pelvic floor muscles? I thought it was just the sphincters that controlled anal continence?

Its interesting you asked as I'm actualy going to see the man who invented the pelvic floor ultrasound device, Professor Peter Dietz on 25th November. If you google his name you'll see his bio on the University Of Sydney page (couldn't get link to work!!). He's a world leader in pelvic floor damage after childbirth so I'm hoping he can answer some of my Qs and point ne in the direction of a more helpful colorectal surgeon!! I'll be sure to let you all know what he says once I see him.

I was doing the bog standard pfexercises but am now using weights, an inflatable balloon up my bum that i have to squeeze and resistance bands in all different positions to stimulate the muscles. The physio mentioned the electronic stimulator but said we wouldn't use it unless I didnt progress enough on my own...? Have you found it useful? And ta will check out the 'any old prolapse' thread

Gosh that was long!!! Sorry everyone hope you all have a lovely wknd and cravingcake hope bub isn't partying too hard in your belly and letting you get some rest

Here is the link to Professor Dietz's bio if anyone is interested.

Wow, thank you everyone for your kind welcome. I genuinely can't believe how many women there are that have to suffer these horrors to have their children. I just never knew.

Jacksamania, really helpful to hear your recovery times. I hope that it will be a similar situation for me, fingers crossed. At least I know now what works for me in terms of making myself comfortable, and hopefully I'll be coming out with a healthy iron count unlike after the labour which I'm sure will help me feel much better!

Neptuna, I will think about seeing my GP for the anxiety. I've had trauma counselling in the past for a totally unrelated PTSD, I was sort of hoping that my days of therapy were over! I have spoken to the hospital in the last few days to hopefully arrange a postnatal debrief which I'm hoping will help me to better understand exactly what happened and why I've ended up like this. I don't even know where my stitches were or what degree my tears were. I don't know if I wasn't told or if I just didn't take it in but all I remembered being told was I had a simple episiotomy. When the gynae consultant examined me he said I had multiple cuts and tears so not sure where the miscommunication was.

Anyway, I hope you all have lovely weekends. I plan on having several .

I'm currently having some (6:30 pm where I live), so cheers :o

Please keep posting. I had hideous PTSD after DS's birth. Lots of trauma therapy .

Neptuna, I will be having my hysterectomy done time after January. My very lovely and unsettlingly good-looking surgeon has switched hospitals, and is scrambling for more operating room time. Shitty for me... he's now at the hospital where I had DS. :( Talk about flash-backs :(
It was a bad day when I found that out. It just seems horribly unfair that that's where I have to go to leave my poor uterus behind. :(
Pity-party for one, right here.

Neptuna - I think the wind settled down around 9-12 months pp, as that's when I remember feeling as most back to 'normal'. I don't know what else you can do, and really don't envy you as a teacher, I can completely understand the stress and anxiety you must be feeling about returning to work. Also, you said in your post that you cant think what you did wrong - let me be the first on here to say you did nothing wrong! These things happen and I think it is more often than not a combination of any number of things, baby in difficult position, midwife not guiding you properly etc BUT it is definitely nothing you did (or didn't do).

Thankfully my current issues seem to be due to pregnancy and should (but who really knows) go away once baby is here. I weighed myself today and I'm 10kg's heavier than I was before conceiving and most of that weight is bump so there's a hell of a lot of extra pressure on an already stressed area. And yep, I'm having an ELCS.

Hope you are all enjoying the this weekend - I'll be joining you in 10 weeks and counting

Hi Neptuna. VERY glad you are seeing someone else. As I was reading through your post, I was thinking you need a second opinion. I think you need anal manometry. This will show the strength of the inner and outer anal sphincters both at rest and when squeezing. If Prof D doesn't suggest it, get him to justify why he believes it is not necessary in your case. (This is a general rule of mine - get all drs to justify whey they do or do not want to do something, and whey their opinions differ from others you have received! Always good to get them thinking )

Whilst the anal sphincters are going to be the main muscles controlling continence, the other pelvic floor muscles are going to pay a part too, especially if the sphincters are damaged. My puborectalis (the muscle that runs as a band under the perineum was completely severed and I had a 3 cm gap. My sphincters are intact, but weak and thin. Before I had the puborectalis closed, I had problems with faecal incontinence and I couldn't hold wind to save my life . I've now had the repair and I am progressing with physio to build my strength up. I've had no accidents and am getting better at holding in wind. I think you need someone to say for definite whether all your pelvic floor muscles are intact - the fact that you were stitched at the time and the fact that you have healed externally, doesn't necessarily mean that much. Hopefully this Prof can determine what is going on.

As for physio - it takes a LONG LONG LONG time to build strength up. Muscles have been damaged. Nerves have been damaged. It takes so much longer than it does for an otherwise healthy but weak pelvic floor to get strong again. In my case I was scoring an impressive 0 out of 5 when I first went to see my physio before I had any repairs. With neurotrac and with pfes I for to 3 out of 5. I had what will hopefully be the last of my repairs in February of this year and am now scoring 3.5. We hope to get me to a 4. Unlikely I'll get higher than that, but 4 is adequate.

See what Prof D says about physio and whether he wants you to see someone else. You need to see a specialist. Mine only does gynae, and that's the sort of person you want. I can understand her wanting to see how much progress you can make on your own, but frankly if you are already having to stick things up yourself, I'd advocate a stimulator - my main reluctance would be that it can be upsetting to stick thing up yourself, so if you can get away without having to do so, then it's better. How long have you been doing physio? Has she 'scored' you for strength and endurance? If you are doing your exercises diligently, and you've made no progress after a month, I'd really try to persuade her to go for a stimulator. BTW - please don't use one on your own! The programmes are complicated and you run the risk of hurting yourself, especially if you have nerve damage and might not be able to feel what's going on.

Good luck and please let us know how you get on!
XX

Jacks hugs and wine. Have been thinking about you lots and wondering how you are. XXXXXXXXXXX

Hi Saspi. So sorry things have been so horrible for you. I haven't had the surgery you mention, but I have had several repair operations, two of which involved a major internal dice and splice. Although my surgery sounds as it if was more invasive than your's will be, I'd strongly recommend getting in as much help as you can for your recovery period, and then breaking yourself in gently to getting back to full Mum and work duties. The healing this time round will be very different from how it was last time round.

The emotional stuff sucks. Like Jacks and many others here, I ended up severely traumatised. I'm still having trauma therapy and it's helping loads. Your feelings are completely to be expected, given what you've been though and the face that you still need surgery. Have you talked to your DH about how you feel? Loads of women who had relatively straightforward births are really having sex 6 months after giving birth. Please don't feel guilty. I totally get what you mean about your post birth body. I was disgusted by mine for so long. I'm still not altogether positive about it, but I'm doing better now. Getting fixed went a long way to feeling less negative about myself, and I'm sure it will for you too. Other things that helped me, were little things, like always wearing a favourite perfume. Buying a new top or scarf. I made a decision that even though my body was broken, I wasn't going to look as if it was broken.

As for other kids - I think you would be a prime candidate for ELCS, if that was something you wanted. If that is a big worry for you, can you discuss it with your GP (if you have a good relationship with them) or with the surgeon who will be operating on you? You don't have to make a decision that ELCS is what you want, but if you can find out that it is an option for you, should you want it, that might help with some of the worry.

XX

Saspi I think an episiotomy is a 2nd degree tear, unless it extends further and becomes a 3rd degree but you would've been taken to theatre if that was the case. Good luck with the birth debrief and thinking about seeing your GP, please come back and let us know how you're going with it all

Oh Jacksmania how utterly shit indeed!!!! Is there no way at all you can have it done elsewhere? If not, would you be able to visit the hospital once or twice beforehand to 'desensitize' yourself? I still get funny going to the hospital where my birth was, and there is no way I'm ever visiting anyone in the postnatal ward there after they've had a baby!! I don't know much about hysterectomies but I thought they could perform them while still leaving the ovaries behind to avoid instant menopause, is that an option for you?

cravingcake yes I think I've probably got the worst job possible to have with an unreliable sphincter!! I can only hope the gas problem continues to improve in time, as it did for you, but as each month passes I get less and less hopeful

I know, I know I didn't 'do' anything wrong!! I just get so confused...she was tiny (6lb oz), I wasn't induced, no forceps/vacuum...should I have not been flat on my back? Should I not have pushed so hard, as I was told to do? I get angry a lot, at women who had perfect births and didn't tear or even those who had EMCS cause their bits weren't shredded. And it's not the sort of thing you can talk about!! I mean, if I was in a horrible car accident and had a limp for the rest of my life people would empathize and say things like "oh poor you, that must be so hard" and "it must really limit certain activities", and yet there's no recognition for what we've been through. I also resent the fact that I wasn't informed about these serious risks of vaginal birth, if I had I may have planned my birth differently. Doctors wax lyrical about the risks of c sections, but nothing about incontinence from vaginal birth...

Sorry, I shouldn't go on when others on here have been through worse It's all still rather raw for me I think. I really do hope your current problems disappear after the birth!! I'm very worried about the same thing happening to me during the next pregnancy. Did you have the smearing issue at all before this pregnancy or is it completely new? When is your ELCS booked for, 39 weeks??

And yes not long until the now, yay!!!

cardamomginger thankyou for your thoughtful and detailed comments, you've given me a lot of information that I hadn't considered before.

I will definately ask Prof Dietz to refer me to another colorectal surgeon, preferably one with an expertise in birth injuries and not just your usual piles and fissures bum doctor. I agree I probably need the anal mamometry, I don't know why it wasn't suggested during my colorectal appointment. The entire appointment was about 20 mins and went something like this: discuss symptoms, be taken off to have endoanal scan, discuss results (both sphincters intact but thinned) told pelvic floor exercises will exercise external sphincter to help delay a bowel movement but won't help internal sphincter which stops passive release of gas, told internal sphincter must be damaged but can't be repaired (he thought there might be nerve damage too?) offered collagen injections to bulk up internal sphincter but told that won't be trialled until I'd completed my family...sent off on my way!

It does sound like I need someone to tell me if all my pelvic floor muscles are intact, and Prof Dietz has the technology to do this. Neither the gynae or the colorectal suggested pursuing that option, so many of them don't know what the hell is going on in terms of serious tears and pelvic floor damage!! I'm assuming your puborectalis tear wasn't identified after birth and therefore not stitched? I'm pleased to hear your incontinence has eased and wind control is improving!! Can you hold wind when standing/walking? I'm lucky in that I only had incontinence during the first 4 weeks after birth, but I still get bowel urgency and can't delay it very long. I'm ok at holding small amounts of wind if seated or lying down, no hope of holding it when standing or walking though and that's what has been distressing me.

As to physio, I'm very impressed you're scoring a 3.5, woot woot!!! My physio came recommended by a pelvic floor academic at my local university (Dr Pauline Chiarelli, she's written a few books etc on continence and 'women's waterworks'). Her speciality is pelvic floor and continence physiotherapy. I started in late June (birth was in late Feb this year) and scored 1/5 for both vaginal and anal strength...was quite upsetting! As of now I'm scoring a 4 for vaginal strength but just a 3 for anal strength. The balloon I've been using got me from a 2 to a 3 in the back passage but my progress is now starting to plateau, I might ask about the electronic stimulator and see what she thinks. I will definately take Dietz's advice though on whether I need to see someone else as I really need to be as strong as I possibly can be. How long have you been doing physio for? Do you have to do exercises on a daily basis?

Thanks again for your input, better advice than most of the doctors I've seen!! If you have any further information about tearing, the pelvic floor, incontinence etc I'm all ears. I always feel better about a situation I can't 'control' if I'm armed with as much information as possible. Also, I can't remember if I read it or not on this thread but I can't recall what happened at your birth? Was it a 3rd/4th degree tear too?

xx