Spincter injury, fistula - support eachother?

[Cyee]

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.

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

Ps Im due to go back and see my consultant in a few weeks time and if the diltiazem cream has not worked she said she would do the op to cut the anal spincter muscle, so Ill obviously be asking her questions, risks etc so Ill let you know.

In the meantime though I would highly reccomend getting some movicol and get yourself back to the doctors.

PLease let us know how you get on, you dont have to suffer like this.

Hi Flourybaps nice to hear from you again.

My swab confirmed the infection,and I have had a weeks worth of strong Antibiotics.Unfortunately the discomfort and discharge is still there,so have spoken to the Nurse Practicioner,who prescribed me some more Antibiotics.

Started to feel "itchy" Hope thats a good sign,like with External wounds,that things are healing.Still haven't seen anymore stitches come out though,I'm now 4 weeks and 1 day post-op.

Snap with the holiday too! We are going away in June too.Would like to imagine that things might be ok in the hmmm Bedroom dept. by then.

Glad things seem to be progressing well for you.

Its a lovely dilemma isnt it, I just cant make my mind up where to go, looking forward to a nice romantic break. And yes I think we are both hoping Ill be 'in working order' by then!

i suffered from an anal fissure for a year, and it was agony and awful. having a thread on mumsnet was the most amazing support and i'm glad you have found each other!
my story was forceps delivery, fissure that never healed. i did go for surgery after due consideration. it didn't work for me, in that it didn't heal the fissure although it didn't leave me with any problems. what worked for me eventually was when i stopped breastfeeding. i think my issue was hormonal after the initial injury. once i stopped breastfeeding my periods came back and i healed. but that took a year.i tried a lot of things and this is what i advise:
diliatzem. i think thats what its called? this was an american cream, when i had my fissure they weren't prescriping it yet but i have a really nice doctor and i asked for it. its a calcium channel blocker. and it really helped.
water water water.
much fruit, keep the stools soft.
leaving toilet seat UP when you poo, and preferably raising your feet off the floor.
bath afterwards.
now i am healed but if i go out on the lash i always get piles afterward.but there is light at the end of the tunnel. best of luck to all of you.

Thanks so much for taking the time to reply everyone.
I will definately try to get myself some of that movicol, my stomach is always huge from the lactulose.
Will also ask GP about diltiazem. It is so nice to have people that know what i'm talking about. Usually people just say oh how is your "sore bum"? I just don't think they realise.
Maebee - a whole year?! That must be awful for you.
Flourybaps - Do let me know how you get on with the consultant, hope the diltiazem cream works, the thought of that op is not very nice is it?! But i am sure the short term discomfort will be worth it if all else fails.
I think a trip to the doc's is needed. Got the consultant again on the 20th so i will see what they say. Last time it was a totally different doctor and he didnt even examine me just told me to keep going with the cream...grrrr.
Oh yes, Cyee, i am near Bristol. Seeing colorectal lady ms pulleyblank at southmead hospital. But as i said, a different man last time...and all they say is theyre reluctant to do the surgery on me. maybe the plastic surgery op but i cant see how that will help much as it keeps recurring. But you never know. I'm armed with everyone's advice now!
Will also ask about the women's health physio you mentioned.
Speaking of DS being an angel, he's squeaking now so better go, but will check back to see how you are all getting on.
xx

Hi Misty - I'm expecting to see one of the Frenchay plastic surgeons at my local hospital (RUH) for my problems. Everyone keeps telling me how shit hot he is. Hope that proves to be the case.

I saw my colo-rectal consultant last Friday and I've already had my MRI which will go to mr plastic man. But bleurgh took two valium (I find MRIs very traumatic) which was one too many so felt shit most of today!

Flourybaps - I think I've had three showing-nothing-swabs when I was oozing green pus! So keep on the case.

Hi all,
Hope you all had a good weekend.
Thanks for your good wishes for my FIL Hi Maebee - can't believe you're punished so badly for going out on the lash! But very good tips for the toilet set - I'd heard the one about raising your feet/being on tiptoes, but not about putting the toilet seat up. Genius.
I hope all your bits get...ah.. back to working order soon. Speaking for myself, the first few times I was nervous and it was a bit tender at first but now (nearly a year on) things are fine
Take care all,
Cyee

hello people
so glad to find somewhere that has people who have had a similar expereince to me.
i had a large retocele nearly 2 weeks ago. Was told i had many internal and external stitches. It felt awful much much worse than any of the 4 awful briths i had had.
anyways i ended back in the hospital on dy 10 with fresh bleeding and the doc wanted to insert a speculam ouch my leg was shaking needless to say he could not do this.
i was told i had an infection and finished my aniob 4 days ago.
i am still finding it incredibly sore to sit down on my 'bum area' and when i do i can only manage about 10 minutes.is this normal?

i have been out for 1 very short walk around a supermarket and i find im taking very slow small steps. I still can not drive. Is this all normal?

i feel strange down there as it er er er cant explain just weird sensations. Maybe very achy and tender and pulling sensations. I have tried to look down there numerous times but the area is still swollen and bruised wow i am shocked at the colour of it (sorry TMI) but i feel a bit butchered even though im sure im not.

As for having a bath i still cant have one as i find it hurts to sit/squat down and get back up again so am still havong just showers. Also i was advised by the hospital not to bath for the first 2 weeks anyway.

its so good to hear others who have suffered with problems in these areas.

Ive also been advised that i may need another op as my bladder has prolapsed,

Having these babies, they are worth it but the damage it can cause down the road.

Welcome Kentmumtj,

Sorry to hear about your experience - but glad you've found this thread. SOunds like they did loads of internal stitches and not to put too fine a point on it, they really have to push and pull to do this. The bruising is signficant and (in my exp) takes a good few weeks to calm down. The bruising was what stopping me sitting down and causing what felt like an almost permanent ache. I know we had differnt things, but I also had loads of swelling and my memory of what it looked like was a dark dark red/brown... not like my bits at all!!
If you're at all worried about the walking/driving I'd speak to your doc. To me it sounds like you're recovering well. Remember you've had loads of work done - if it was in any other context (than childbirth) you'd be forced to rest for weeks to recover!!
Hope you start to feel more like yourself soon and stick around, it's good to have you here

thanks cyee

i must say it is reassuring to hear so many others as i to have found it a very taboo subject.
I have no idea what my work colleges think ive had done as one phoned me and asked me if i still had my walking stick lol.

im not worried about the walking or driving too much i think im just surprised how long it is taking i remeber driving much sooner after having all of my children but i guess i have much more of a deep cut covering a larger area.

im hoping to go back to work next week hope im able to

From my experience kentmumtj, I did say I'd go back to work after a week I soon realised that this wasn't going to be the case,and my Rectocele Repair was quite small.

I think the best way to gauge it, is,as you are recovering you feel like you could cope with work and driving,if it the moment that seems unlikely,then even next week it is likely to be,IYSWIM.

If you feel ready this week, then you will be ok to rtn next week.

I thought as my job is mostly sedentary and only mornings I'd be ok.But if you are still sore now,it is difficult to sit for long periods,and not change position the way you can at home.It also does tug at the internal stitches,if too much strain is put on them,you will undo all the work that has been done.

Sawyer when did you have yours done?
i had mine done on 24th Feb

I am signed off until next Tuesday which will be 4 weeks post op. I dont work full time i work Mond. Tue and Thurs in office and Wed from home. My job can see me busy and does involve sitting in front of comp (I am a Social Worker) obviously if i cant drive at that point i wont actually be able to go in anyway.

I too like you originally thought i would be off work for a week lol......arent we silly

Oh and ive also been told i may need to have the front wall think its called anterior anyways bladder wall operated on in the future which would mean more time off work and all this pain and discomfort again.

Has anyone had this repair done?

Hi everyone
I've been pointed in the direction of this thread from another mumsnetter, I have been working my way through past threads and finally plucked up courage to say hello!
I'm not used to online chat so firstly apologise for writing lots and not using abbreviations! I'll try and get the hang of them!
I don't think what I am going through is anywhere near as hard as the rest of you, you all have my sympathy and yes it is fantastic to be able to talk about such a taboo..

I have put up with things since the birth of my second child who is now 2.5 and finally plucked up the courage to talk to my gp. Having seen an anorectal consultant a couple of weeks ago I have been told I had a third (possibly fourth) degree tear at her birth which wasn't spotted. I gave mbirth in a midwife only hospital. I Have healed but obviously muscles are very damaged so my control down there is pretty rubbish. I am still trying to get my head around it really. Reading your discussions is answering some of my questions, I realise I have been in denial for a long time, as well as accidents I have some pain (worse when I'm having a period? is this scar?)
Words partial prolapse were mentioned when the GP examined me but the consultant didn't mention this.
My consultant has given me some exercises and said there may be some nerve/shock? therapy available but ruled out surgery as success rate low. LittleRed recommended asking to see womens health physio which I will do.

So for now I just wanted to say hello! I am trying to get my head around a lot of the medical terms can anyone recommend a good site to look at to explain them all? Also has anyone else been in similar position where the tear was missed?

I'm in a funny place at the mo as feeling very angry this was missed but also angry at myself for not doing something sooner and pushing more after the birth when I felt things weren't right. So silly that embarrassment kept me quiet..... But then I have a healthy little girl so....!!

Welcome Bubblejet!

As always - glad you've found us but sorry you had to find us.

I used Google a lot for the terminology, not sure if there's a good site. Why don't you stick your questions up here and we'lll do our best to help.

While I didn't have a tear, my injury was missed. I had a fistula which is basically when there's a hole in the tissue. This can be caused by long, obstructed labours, but in my case (where labour was fine and quick) it was probably caused by some kind of weakness in my tissue... possibly a connective tissue problem. Anyway, I, like you, noticed things weren't quite right and went to my GP and thus started the whole palaver that led to this thread

I was very annoyed that this was missed, though I am probably now in a place where I think it was unlikely my midwife could have seen it as it was barely noticeable on a scan, even though it was affecting me. Because my labour was so straightforward the midwife had no reason to be especially vigilant either. It's taken me 1.5 years to feel/be so chilled when saying that. Progress!

I found the exercises very very helpful and have also heard good things about the nerve treatment because sometimes the injury damages the nerves that give us our anus control - so it sounds like they reckon they can maybe shock yours into action.

Finally, depending on how bad your personal situation is, there is amazing treatment available when people have lost some/all of their anal/rectal control. I met one woman who had the equivalent of a tiny pacemaker 'installed' to help her and sounded like it changed her life. Her condition was very very extreme though.

Definitely enjoy your little girl, who by the sounds of it is about a year older than mine. I worry she's going to feel guilty when she's older and realises what joys of post-birth her mother had to endure!!!

I look forward to hearing more from you Bubblejet, take care of yourself and feel free to ask as many questions as you need to.

Hi Cyee and thanks for the welcome!

ok embarrassing question number one... I had read in the discussion about a fistula. Now I have been examined by the consultant (she did various tests to measure the strength of the muscles and an ultrasound to take pictures of the muscles) would she have spotted if I had one?
When I try really really hard to hold in my wind (usually if i'm sitting down as if I'm standing up I have no chance) then I move it feels like the wind is coming out of my fanny (no idea what language to use here! to be clinical vagina!) Could this be there is a small hole or is it just the sensation because lets face it everything is so big and flappy now! Similarly sometimes when I wipe myself I can't work out if its just in a mess (as often I haven't realsied I have pooed or realised too late) or if some faeces have come out of the wrong place. I don't know why I didn't ask the consultant this last time I think it is taking small steps to come out of my denial...

My labour was fairly quick 5 hours start to finish but only really properly in the last hour. But my first was very similar and I only had a first degree tear that time. When I did deliver the midwives were extremely busy and as a second time mum I was left a lot (but happy to be at the time) Just before they stitched me there were 3 of them with a big torch have a good luck but I was so strung out on gas and air both my husband and I just giggled at the torch and didn't think to ask any questions.. Looking back I realise now they were probably debating 3rd degree or not and concluded not.. bummer (ooh bad joke!)

I am thinking of asking my sister to come with me to my next appointment and take a list of questions with me as I just go into submissive mode in front of doctors, who knows why! So any advice from your own experiences of things I should be asking would be really helpful - thanks!

Yes our poor little girls! Hopefully by then we will have much mistier memories! Sorry for the embarrassing questions but thank goodness for this place I can ask them!

note first use of icon!!

I'm sure Cyee and the others that have suffered in the way you have will answer too.But there are Threads further back re: Wind from Vagina (Feel free to use whatever terminolgy you are comfortable with,I'm a Nurse,so usually get "technical"!)

and "pooing from vagina" too.

kentmumtj I had my Op on 10.02.09,so I am 5 weeks today.

I went back to work after 2 weeks,and apart from tiredness I'm fine.The health proffessionals recommend that you are able to do an Emergency Stop in your car,without it causing you pain etc.

I was able to sit easily afterwards,although I got "numb" quickly and sore,so changed positions frequently,and it was a relief to go to bed (as I sleep on my front)

Ha Bubblejet - well done on the smiley face!!

Our experiences do sound kind of similar. However you're right that there are 2 options:

• wind can feel like it's from vagina but actually just have leaked out and travelled back. This happens to me occasionally now, depending on what way I'm sitting I think. Pelvic floor exercises also help with this
• if it is coming from vagina then yes you may have a fistula. Depending on the scan they may see it. Apparently fistulae heal up and then open again, so I guess maybe it might not have shown up? I'd ask them specifically about that, as at least you'd know then.

On the poo front, I can imagine it's hard to tell where it's come from. Thankfully I didn't have too many accidents, however if my stools were a bit soft then I noticed a bit of brown discharge on the toilet visits following the poo. So it wasn't clear to me at the time, but was clear afterwards that some poo was in the wrong channel.

I totally recommend taking someone with you. I didn't on the first consultant meeting and really regret it - I was a basket case and also do the submissive thing you describe. I took my SIL (sister in law!) next time and that was much better.

Hope that helps - bring on the questions!

PS Also recommend looking at older threads... think one might even be mine under a different name... back when I actually cared about TMI!!!

Poor you Bubblejet. Sounds a great idea to take someone along with you.

Hi Bubblejet,
I had the "where is the wind coming from" thing too. And the "I can't hold it in unless I'm sitting" thing!! As Cyee said, when you pass wind, some of the air can "zip" forward and end up in the vestibule of the vagina (just inside, near the opening) because things are, well, a little looser after passing a baby through! Then, when you get up, the air is forced out, making you think you've passed wind from your girly bits. I was a little freaked out until I figured it out.

Welcome to the thread by the way. I'm so sorry you need it but glad we're all here for each other. And there is no TMI on this thread. Really, none. The things I have told you all on this thread would make my RL (real-life) friends as well as my mates on other threads run screaming.
Not sure if that's funny or now... heck yes, it's funny. It has to be. Right?

Thanks Jacksmama! I will work my way through old threads but yes I think that is what is happening. And yes it has to be funny! At last I have found people I can be honest with! One question... what is TMI?! sorry I really need to pick up on this chat stuff!! I'm 36 but feeling like my mum not getting the techie stuff!

Haha you're all very funny ladies

TMI is Too Much Information... usually used as a warning on other threads. We positively invite it on this one!!!

Have a good evening everyone. About to tuck into a St Patrick's Day vino and sausage, mash and onion gravy...Mmmmmm....

loving this thread it really is good to talk and hear other peoples experiences

Sawyer - I hear what you say about the emergency stop and i think i would be able to do that except i still find it incredibly sore to sit on my 'bum area' as i am less time post op than you do you think this is normal? even though none of it seems normal lol. I have tried sitting further back onto my bum and more forward onto my vagina and both feel very uncomfortable and sore but in different ways.

cyee - thinking about your comment about children growing up and realising what problems their births caused makes me laugh as i am going through this right now.

I have 4 children all were complicated and traumatic births but my 2nd child who is now 15 caused me terrible internal/external tears. In fact i think she just tore me to pieces at the time. Anyways post birth i was under a consultant and they offered me an op (the op ive just had done) but did say i would not be able to vaginally give birth in the future. Apparently i had torn my inside muscles. I had not finshed having my children so put off the op. Roll on 15 years and 2 more births plus age and naturally in got worse and i needed my repair.

My daughter keeps saying 'its all my fault' and i think she felt guilty especially seeing me in pain and she actually avoided me for about the 1st 10 days post op. She just would not come and see me or talk to me.
I have had to explain that to her that it was my choice to have children and that i wouldnt change it even if i had my life time over again. She is slowly coming around but she really does blame herself which is hard and upsets me seeing her like this.

the strange thing about my op was seeing the ccnsultant this time around and realising it was the same man that i had seen 15 years ago. I wasnt sure to be scared that he had got 15 years older and still operating or glad that he had more expereience lol.

and welcome bublejet i must say im quite embarrassed talking about these kind of things and did not question much until the day i was lying in the bed waiting for my op.

When the consultant came to see me i bombarded him with some extremley embarrasing questions which i now cringe at. Think he thought i was nuts lol

Thanks kentmumtj - sending you lots of get well wishes.
My mum suffered terribly with me (I'm the second). She had to have a blood transfusion after the birth and I still have to piece together what happened as she brushes over the detail. I then remember when I was about 11 she had a hysterectomy and I know now she had a bladder repair too. Again I still don't know the ins and outs, she is telling me more as I am telling her what I am going thro now. She turns 70 this year so obviously was a long time ago and medical procedures have improved etc but nevertheless I do feel bad for what I put her through! But you know now I've had my children I realise nothing would have stopped her doing it all again (and look at you - 2 more children, amazing well done!)
I am sure when your daughter is older and has her own family she will understand more.
I also worry I have put my sister off ever having children!
Can I ask you what a retocele is?