What to expect from gyne appointment ?

[IdogMax]

After a disastrous smear, where by the speculum would not stay where it was supposed to be and the gp confirmed the reason was not because I have fabulous pelvic floor muscles but rather the complete opposite !
After asking a few q’s about frequency, and my ability to hold on when coughing/running/jumping she made a referral to a gynaecologist, this app is fast approaching and I’m a bit nervous and don’t know what to expect, also tmi alert!! in the last couple of months I’ve been having trouble passing a motion - not constipated as such, good diet plenty of fruit & veg - just can’t seem to push it out ( it gets as far as the exit and kind of bulges but won’t leave!)so I have to support underneath and kind of push from inside.
Would this be related to lack of said pelvic floor muscles?

Sadly yes. The good news is that your gynae is an expert, knows why you’re at the appointment and will have seen it all before.

Tell them everything and let them explain your options. Good luck.

Thanks for replying molly , oh I’m dreading it , not usually bad with things of an intimate nature, have had treatment for cin3 and yearly smears for the last 4 years so I’m used to having my hoo ha examined, but I don’t like the hospital I’m going to and I’m worried I’ll have a grumpy old guy!

Ask for a female doctor OP. No guarantee she won’t be old and grumpy though

toads I will ask actually! Thanks for that I’m feeling a bit daft because it never entered my head that I could!

You need to see a urogynae and you'll have been referred to a consultant who may be male. You will have a female chaperone though. I think if you specifically want to be seen by a female consultnat you'll need to have asked before referral. It sounds like a rectocele - the wall between the vagina and rectum is weak so the rectum bulges into the vagina when its full. So pushing up on the perineum or back on the vagina wall helps you get it out. Glycerin suppositories help if you are struggling - and avoid straining at all costs.

Good luck

Does anyone know if there will be a physical exam? I suppose there will, silly question! What will it entail?

I'd expect a physical exam with possibly a couple of different positions and be prepared to bear down if asked - this will help them see any prolapse. Also may be a rectal exam too if they suspect a rectocele as they can feel the thin wall between the rectum and vagina. It isn't as awkward or uncomfortable as you might expect and they've seen it all before.

I second that you need to see a Urogynaecologist. It sounds like you may have a prolapse. This can be detected by a physical examination by lying down or standing and an MRI.

Hi all, thanks for the replies,

So my appointment was yesterday and it was no worse than a smear tbh.
The consultant was a man, but he was a lovely man! Totally put me at ease, asked all the right questions and had a sense of humour which was great as I tend to cover my anxiety about things with humour !
He did a vaginal and rectal exam, did get me to bear down, and also to use my pelvic floor muscles - which he said were absolutely fine! he said I was showing off )

I do have a prolapse and he has recommended a “sling” also I have a rectal prolapse that he can fix at the same time. He wants me to have a urodynamics(sp?) test, and says it’s unlikely to change the need for an op and as the wait list for the op will be 18mts, he has put me on the list while waiting for the test.
He will call me back closer to the op to talk it through, and gave me a link to a presentation he did on YouTube about prolapse which was very informative.