Continued support for SPHINCTER INJURIES, FISTULAE and other CHILDBIRTH INJURIES - the Ragged Bits Thread

[Jacksmama]

Hi all,
old thread here.

Cyee started this thread in May 2008 after her op, and it's been a haven of support for so many of us who have injuries to our bits from childbirth. Especially with respect to sphincter injuries, fistulae and incontinence after childbirth, there seems to be such a lack of support for women, and the entire subject seems to be taboo. It's as if most MD's think that "a certain amount of damage is to be expected after birth and you just have to live with it". Well, that is simply not the case - and this attitude is unacceptable.

There are all kinds of Ragged Bits stories on this thread. Be aware that THERE IS NO "TMI" HERE - this is the one place where you can spill it all. If you read through the old thread, which is nearly full, you'll see that someone, somewhere, has probably experienced it - whatever it is! So don't be embarrassed or ashamed... we'll tell our poo stories if you'll tell yours.

And also - there are success stories here. Several of us who have been through the medical mill have been successfully "repaired" and are "fully functional", so to speak or even expecting again. In those cases, please join us for Pervwatch - the "after action" report for anyone who is once again venturing into marital relations!

Welcome everyone. We're sorry you had to find us, but we're glad you're here.

Hi all, i'm new to this. I had a c section 5 months ago, & now i'm always going to the loo. I can hold my wee in, but i'm always dying for a wee. Is this normal?

It's worse than when i was pg

Lovinmybois, I would say that's probably not normal. Have you been to your gp? Might it be an infection? I have heard that there is a risk of bladder damage with cs but I'm afraid I don't know a great deal about it.

Have you been doing pelvic floor exercises? Do you have leakage or just urge?

I think your best bet would be to see your gp and explain the problem.

I will pop back if you want to chat.

Hi Kentmumtj! Lovely to hear from you. Great news on the action... takes me back to pervwatch days :) I also have that tender bit. Some day I'm going to get round to speaking to doc about whether there's anything that can help. I vaguely recall there being creams like oestrogen gel or something that can aid healing etc. Though I will prob wait til I finally give up bf'ing (DD2 is rather a clingy boob-obsessed mummy's girl.

Lovinmybois - sorry I can't help. Definitely worth seeing someone about. It doesn't sound normal and maybe just is a low grade uti? I had one while 8 months pg and was going all the time, no other symptoms... other than mild contractions .

Right, off to try to make a meal that rival's Ella's Kitchen pouches as DD2 has made it quite clear that they're nicer than anything her poor mother could ever create.

Hello to everyone out there... :)

Thanks for the advice. Yes, i still do exercises. No leakage, just the urge all the time. I didn't consider a possible infection. I'll get to the docs very soon.

Let us know how you get on

Ladies, can I join you? I've been lurking on this thread and the previous one since DS was born - and he's now over 2 years old. I'm pretty sure I have a rectocele and a prolapse, missed at my 8 week post natal check, a coil fitting and a check - I was just told each time it was because I was bf! I finally made myself go to the GP this week, and she agreed there's definitely something wrong - as I pointed out, it all seems ok when I'm lying down, so why would it have been spotted before - and I've been referred to a gynae. Waiting for the appointment.

For the record I had a fairly straightforward birth. About 2 weeks overdue, waters broke, but nothing happened, so after 24 hours I was induced. Fairly quick labour - 7 hours from start of drip, and a very short 2nd stage. DS almost 9lb, but I just had a few grazes, and no stitches.

So that's it really. Even though this is the first time I've posted, I've followed this thread, and it's been so helpful, especially in recognising what's been wrong. So thank you Cyee for setting it up.

Welcome TheBuggerofSuburbia :) They seem to use bf'ing for all sorts don't they?! As you most likely know :) I also had a pretty straightforward birth - a great one actually. Kind of makes it worse I think, when there's no obvious reason for the injury. Hope your appointment comes up soon and keep us posted on how things go.
Really glad you've found the thread helpful!

I should also pop in then to say I have found the thread incredibly helpful as I made my decision on DC2's birth. Thank you all for your honesty.

I had an emergency forceps birth with DC1 who was never coming out naturally (head side on but fully engaged, 6 hour second stage). Traumatic labour, useless mw ignoring my instinct that it wasn't right, ineffective pain relief. Lots of bladder damage from the high rotational forceps, lots of internal and external tears beyond the episiotomy, stitches and scars. Very lucky bowels weren't affected, but the bladder has never fully recovered.

I chose an elective for DC2 and he is now 16 weeks old snoozing away here. Surgery was a delight in comparison, healed wonderfully and bladder coping really well considering.

Your stories helped a lot, I didn't post because I was fortunate to avoid the bowel issues (though sex was impossible for many months and had further gynae checks at 7 months to look for undissolved stitches etc). Many people tried to brush off the incontinence as a minor, easily fixed issue. Your thread has helped me see it is far more complex than that. I can quite understand why someone would go for a vaginal birth, but it really helped clarify my gut instinct that I could tear again badly and possibly have worsening incontinence. Especially post menopause (which I am due to get early according to my family history).

Wishing you all well for the future and hope the treatments are being effective.

Congratulations on the birth of your DS! I am really pleased to hear your CS went well lovethesea - we've chatted on this issue a couple of times on other threads. I had a little MN break but did wonder how you'd got on. Thanks for the update!

I plan to birth vaginally next time (if there is a next time!) because although I had a terrible tear last time, I don't feel like I can trust a hospital. I know that's very biased and unfair to say all maternity depts will be as crap as the one where I had DD but that's how I feel. Although I may change my mind once I am actually pregnant

This thread has given me the courage to stand up for better treatment and it has helped to be able to talk about my problems with women who understand what I am going through. You're right when you say people try to minimise your experience. Its as though it's too painful for them to hear so they say things like "I'm sure it'll get better with time" or "fingers crossed you'll be back to normal after the surgery" when you've explained that you won't ever be the same and actually, it isn't just a physical problem.

I did have an idea the other night to post some tips for lurkers but I can't for the life of me remember what they were. It seems a bit patronising now....

Enjoy your DS!

ok, not got time to read but....
Had 2nd baby 9 months ago - first vaginal birth.

I went to a high impact aerobics class tonight (first time since birth)and was shocked when I came to jumping jacks and could not control the weeing . Never happened to me before. Is this normal?

Also I have found sice the birth, im so constipated, it's like my bowel is slow and not as stong or moving IYSWIM. Hard to explain.

Seeing this post makes me wonder if I should see a doc or just get down to some serious pelvic floors.

Thanks for the welcome Cyee. Hulla, I think tips for lurkers is a good idea! No word from the hospital yet, I'm expecting it to take a few weeks, but I'll post again when I hear. Hope everyone is having a good weekend.

cyee - when i had my last smear the nurse told me i had a lot of scar tissue so i guess thats what the ender area is

sneakapeak, in my experience, the leaking after childbirth is quite common and can probably be improved with regular and effective pelvic floor exercises.

I thought I had no bladder problems until I recently found myself peeing whilst I'd squatted down to put some shopping away. I have been dedicated to pelvic floor exerciese since (about 2 months) and felt a definate improvement. I recently went on a huge trampoline with my dsis and dm - both of whom leaked wee and had to get off. I didn't but I am fairly sure I would have if I hadn't had a months worth of PFE under my belt!

I have also experienced the constipation. I had a phase of finding that I needed to go to the toilet but it was kind of going at it's own pace. I couldn't control it to keep it in and I couldnt get it out either. I think that was muscle weakness (just a guess though).

What was your birth like? Have you been doing PFE since your dc was born?

I think it can also be related to nerve damage (common side effect from pushing I think). My surgeon believes that the PF takes about 2 years to recover from vaginal birth. I find that my symptoms are changing even now (20 months PP).

I would recommend seeing your GP and explaining the problem. They may do a squeeze test to see how strong your sphincter muscles are and maybe refer you for a scan?

Let us know how you get on.

Thanks Hulla.

I did tear but how badly I don't know. I had a mobile epidural and didn't feel it that much and didn't ask any questions but they were sewing away for a while!!
I was tender for about 3-5 days then it got gradually better and I forgot all about it.

I haven't been doing any PFE excercises . I honestly thought id been untouched by any problems as it all looks ok and apart form the constipation, I was fine.

Im now finding since my class im having the problem with normal daily things.

I think ive done the damage with Bodypump (weight lifting) then obviously the high impact class - bodyattack hasn't helped. I just decided to suddenly throw myself into excercise last 2 weeks and it's obviously been weak and not coped IYSWIM.

Im really scared ive done something irreversable. I love excercise and was looking forward to getting back into it as ive still got weight to loose and have been miserable with myself. This has made me feel even worse.

Im doing pelvic floors now and making sure it's tough enough to make my eyes roll to the back of my head!

A few people have said several times a day but how many?

How many slow, holding for 5 type ones then how many fast ones would be enough to help do you think?

I think my physio said 3 sets of 10 but my psychosexual therapist said she does them everytime she's stopped at the traffic lights.

I try to do them more than 3 times a day and definately do more than 10. I do them if I can't sleep at night

Your GP should have a note from the hospital about your grade of tear and I would probably mention the weak muscle. My tear was only partially repaired when DD was born, the unrepaired part was found by a scan when DD was about 7 months old.

I am not saying that's what's happened to you, I think it isn't uncommon for there to be muscle weakness after having a baby anyway (based on friends annecdotes rather than peer-researched info) so give yourself time.

I think lifting is a definate test of the pelvic floor. Maybe ask your gym if they think the classes are ok if you have a weakened pelvic floor?

Will check on the PFE for you this week

Thanks Hulla x

This is about the best advice on pfe I have found.

I use the pee test to see if I am improving (couldnt stop mid-flow a few months ago but can now) but it isn't recommended to do PFEs whilst peeing.

I think this should help the constipation and bladder control.

Enjoy! x

Hi

I have been wanting to post on this thread for about 6 months, but have been putting it off hoping that if I avoided the problem it might go away. Obviously not going to happen...

I cannot bring myself to go to my GP. I just can't bear the thought of being examined, very petty I know. Especially when I think there is a problem.

I had DS 15 months ago. I was induced at +10, and had a very fast labour (3 hours from waters being broken and being put on the drip). Don't remember much about the birth itself, as it was such a whirlwind, but I do remember the MW saying to me 'don't worry, you're stretching' when DS was crowning. But, I do remember feeling a kind of 'pop' when the midwife pulled his shoulders out. He was 8lb 6.5ozs born, so just slightly bigger than average I suppose. I had a 2nd degree tear, which had to be confirmed by 3 different Doctors, as they couldn't agree 100% as to whether it was 2nd or 3rd degree. At one point I remember one Dr turning to another and saying 'but what about this?' and the other Dr saying 'Oh thats just pelvic floor'

I felt okay after the birth, and thought I had got away without any real damage. So, in a stupid act of rediculous bravado, I went on a bucking bronco 4 weeks after having DS (OMG this sounds rediculous!). I am so damn stupid, and I think I have probably brought these problems on myself. I always thought I had reletively strong pelvic floor muscles, have always been able to stop wee mid-flow etc. So, I was complacent post-birth, and did no exercises. I thought everything was okay, until I started playing football 7 months after giving birth, and realised I have stress incontinence now. Which I am devastated about, and still haven't been able to tell DH. After I realised this, I thought I would do a bit more, erm, investigating, and it seems as though I may have some prolapse too. Looking in a mirror, I am guessing the front wall has collapsed slightly, but if I am being totally honest, I dont really know what I looked like before? I didn't make a habit of looking IYKWIM! Also, it feels as though my cervix is maybe a fingers-length away from the opening of my vagina. When I use a tampon, I can feel it pressing against it.

We are going to start TTC #2 soon, but I am really worried what damage I might end up doing to myself. I don't feel like I have got anyone I can speak to about this. None of my close friends have had babies, and I am not a very open person anyway; I can't talk to Mum or DH about it. All DH knows is that I have 'some issues' with my post baby body that are getting me down (my words, not his).

Do you think I could resolve these problems with regular pelvic floor exercises?? I think I just want someone to speak to :( Argh, godammit, I have been putting off posting this message for a couple of hours now. Contemplated a name change, but know I will end up getting all confused!

Oh DB & whenskiesaregrey I am so sorry you're having ongoing problems. I'm ill today bit have to do some things for work and then I shall come back and reply to both of you.

In the meantime I'm sending these (((((hugs)))))

Doombar, is the electronic stim treatment from the hospital or have you bought something to use at home?

I found improvements from doing pfe quite quickly once I started doing the exercises properly. I found that I wasn't actually pulling up the muscles at the front which control the flow of pee. It takes me quite a lot of concentration to do it and it feels like it's the last bit of the pfe that I can do.

Are you sure you're pulling up all the pelvic floor muscles?

My surgeon insists that nerves continue to repair themselves for two years post injury. So you do still have lots of time to make improvement.

I was terrified of orgasms post birth because I knew my vagina had torn and the idea of an orgasm made me feel sick. I wouldn't have been able to have one because I associated the entire area with trauma not pleasure. My first orgasms were very weak and I can look back now and see that I needed the therapy I had to let me relax and be able to enjoy sex again.

I don't want to minimise your symptoms, if you say orgasms don't work then they don't work - I am just wondering if you're sure it's a physical thing (nerve damage) or might it be linked to emotional trauma of your injuries?

I think Sacral Nerve Stim seems to be a bit of a wondercure for everything related to nerve damage. I have read a lot of medical research on trials of SNS which suggest that no matter what it is used for (faecal/urinary incontinence) all areas of the pevic floor benefit. When I had my trial I was warned that even though it was for faecal incontinence I might want to pee more - improved messages from the bladder via nerves I guess. The research also suggested SNS might improve sexual function.

Will google...

See here: www.springerlink.com/content/h808k1q5w2645037/

extract:

"Sexually active patients that underwent an Interstim® Sacroneuromodulator implantation (Medtronic, Minneapolis, MN) for control of bladder symptoms were enrolled. Three subjects (43%) felt the device impacted on their sexual function in a positive way (1) by decreasing urgency and (2) by increasing desire" (Edited by me)

I know the study says they underwent the trial for bladder symptoms but its the same procedure for faecal, bladder etc.

Apparently nerve stimulation is an area that is developing all the time so who knows what will be available soon. Don't write yourself off Doombar.

Whereabouts are you? I have been to two specialists. My current one I feel is better but he is less keen on carrying out surgery. My last one was very surgery-happy! You can PM me if you prefer? I hate putting my location info on MN.

theskiesaregrey I have just typed a big reply and IE crashed and lost it. I shall re-do it asap.

Thanks Hulla, I'll wait to see what you say