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

952 replies

Jacksmama · 22/06/2009 20:12

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.

OP posts:
st1g · 08/05/2011 21:02

Hi all, I'm just x-posting to let you know i've pointed cardamomginger in your direction as I've no advice I can offer her.

cardamomginger · 09/05/2011 15:51

Hi Everyone, have been posting on the Childbirth thread for a while now concerning the multitude of post-birth problems I have been having. St!g pointed me in this direction for help with a current problem I am facing:

"Saw yet another gynae about my rectocele last week and he told me that the way my perineal tear has healed has left a thick band of scar tissue at the opening of my vagina. He assumes that the other gynae who referred me to him and who I believe would take responsibility for any treatment or surgery will want to operate to correct this (may well be having some surgical repair work done by this other gynae, so it could all be done at the same time). Am mightily annoyed as when the tear was healing I had ultrasound and did massage to try to break down the adhesions that were forming and keep things soft and supple. Anyway, this clearly did not work and things are getting thicker and harder, not softer and thinner. I was wondering what people's experiences of dealing with scar tissue are. Is surgery a good idea? Is there anything else that I could discuss with him at my next appointment?"

Woudl be really pleased for any advice!!

Thanks X

Cyee · 10/05/2011 21:48

Hi everyone and welcome Cardamomginger. Sorry to hear you've been having a torrid time.
I can only share my own experience with scar tissue. I had a fistula repaired via the perineum and I did have some scarring. I have noticed a huge improvement over time... and with... ah.. various activities ;-) My understanding is that the surgeons will not operate if they think it will make things worse and a few people I know have bee frustrated because they can't get ops. So from an optimistic perspective I'd hope they're only suggesting this for you because they think it will make a real positive difference.
I'm sure you've shared the detail a million times, but what issues are you facing with the area as it is now?
You must feel really frustrated that despite your best efforts the thickening has happened. Grrrr.
Welcome anyway and hopefully others can provide a bit more advice than me! :)

Cyee · 10/05/2011 22:04

Cardamom, just searched and have quickly scanned the other messaged you've posted. What a horrendous experience.
While your experience is very different to mine, I wanted to say that you're absolutely not alone in feeling that your body has let you down and when your outward persona (that you look well) is so far removed from how you actually feel. Faecal incontinece feels dirty, disgusting and terrifying. For many of these reasons people in RL just don't know how to help and let's face it are probably a bit traumatised by hearing our experiences. Please feel free to rant and rave here. Everyone on this thread has an insight into your experience. So don't hold back!
Take care of yourself and enjoy your DD. When I look back at before my op it feels like a million light years away from where I am now physically and emotionally. I wish I could press fast forward and get you through all this crap.
Best wishes
Cyee

Pussinflatboots · 11/05/2011 21:54

Hello, can I join?
DD is 12weeks old. She's a big baby, and first stage labour was very quick (thank god), but was pushing for 2 hours until she finally flew it. This resulted in a tear that dr and midwife argued over (concluded it was a 2nd degree tear). MW fucked up my stitches, got taken to theatre to have them taken out and redone.

ANYWAY, tis still painful so went to my GP. Turns out stitches have healed well, but have formed a skin ridge. Great. So in 2 weeks I have an appt to re-cut and restitch perineum. Great...

Anyone know what this will involve? Fear it will be a local - gave birth on 2 paracetomol but needed spinal for the stitches last time. And recovery time? And will it work? And if anything else is wrong there, will they look or just focus on task in hand?

thanks.

Cyee · 11/05/2011 22:08

Welcome Pussinflatboots - congrats on your baby!
Do you know who's going to be doing the procedure? I would have imagined you'd get more than a local for this, possibly a spinal again? I had my repair op via the perineum (I had GA) and I was off work for 4 weeks, but fine in myself. But I would hope that a repair so soon after the original injury would result in a quicker recovery.
Are you worried about something else being wrong? If you are I'd make sure you discuss/explore before they go in there since you want to avoid any further interventions. I suspect they would just focus on the task in hand since other problems may not be obvious as they rummage around in there.
In terms of 'will it work', I hope so! My op (though different) was successful and I'd hope in your case there's a high chance of success, especially because it's really so soon after the birth.
I wish you all the best. Stay on here and let us know how you get on.

cardamomginger · 11/05/2011 22:44

Thanks so much for your messages cyee. Fisulta??? You poor thing Sad. Glad that you feel so much better now. Am now about 7 1/2 months post birth, and I know that it is still early days, although in many ways it really doesn't feel like it! I think the thing that is freaking me out the most right now is that the extent and nature of my injuries are only now coming to light and are still being diagnosed and assessed. I keep thinking what else is going to turn out to be broken. Will post more on here next week - and hope I will be able to offer some support to others in return. On holiday and staying with the PILs at the moment and only have periodic access to FIL's computer. And whilst I don't mind my Ebay activities being seen, other things a girl really has to keep a bit more private!

Pussinflatboots · 12/05/2011 10:08

haha, cardamom, have just bollocked DH for telling the ILs all about my isshoos. hey ho, I guess dignity will come back one day.
Thanks for the advice cyee - sooo useful. Will wait for official letter to come through, then call and check it all out properly so I know what I'm in for. Please god, not a local!

cardamomginger · 12/05/2011 21:17

OMG puss - that's AWFUL!!! Surprised you only gave him a bollocking and not a debollocking Grin. I am lucky (ha ha, not) in that I also have some bad back and pelvic problems after the birth so if I can't walk that far or appear to be in pain we can attribute it to that. Much more socially acceptable than fessing up that if I walk that much further I might pee/poo myself Grin.

TheWestCoastLotus · 14/05/2011 16:59

Good morning everyone, and everyone new. I was Jacksmama in my previous incarnation :)

I had a perineal repair and a vaginal repair for a horrendous tear that healed badly with too much scar tissue and a clump of nerves trapped in it (traumatic neuroma). It was done Feb 2009 under GA. Overnight hospital stay. Bit sore after for a few weeks but nothing that couldn't be controlled with ibuprofen and paracetamol. And MUCH less painful than immediately post-birth, God, that was grim Angry:(.
It healed beautifully, but I am left with some nerve damage so don't have all the feeling back on the right side of my labia. I doubt it ever will but I don't really care, it doesn't seem essential to my existence :o

I hope that helps a bit?

I, too, was partially incontinent for about 18 months after DS's birth. He was 3 in Feb, and except for those occasional episodes of raging diarrhoea, I feel I'm fine now. If I have the runs, I do keep very close to the loo as I don't feel I could hold it. Wind is a different story - it's the curse of my life that I love Indian food so much, as I really should not be eating so many chickpeas and lentils :o :o :o

14K I had to :o at finding "bumhole" so amusing but it is a funny word, isn't it :o [feels about 5 years old emoticon] :o

My poor bum was fine (beyond fine, actually - I will never again take a pain-free poo for granted) for several weeks, and then the day before yesterday, I had to blow my nose and stupidly did so right as I was sitting down on the loo. What a dumb, dumb, dumb thing to do. Of course the pressure of blowing my nose caused my haemorrhoids to pop out - followed by big poo... OW OW OW OW OW!!!!!!!!! I know better, FGS! So currently I'm suffering again. I don't think it's the fissure recurring, necessarily, as the pain is in a different spot, I think I lacerated one of the haemorrhoids. So I know all about leaning in different directions, or even not quite sitting on the loo seat and taking my weight on my thighs to avoid any straining at all...

And as usual, there's no-one in real life except DH I would want to tell.

Goodness, if anyone's interested in a bit of *poopology", they just need to find this thread :o

TheWestCoastLotus · 14/05/2011 17:03

Oh, and someone recommended me something interesting - if you can get Traumeel cream in the U.K., it can be really helpful for fissures/ bleeding haemorrhoids. It isn't actually intended to be applied on open wounds so it burns for a few seconds but then the burning recedes and it feels quite warm for a minute and then nothing. It's a homeopathic cream for bruises and sprains, contains arnica and belladonna and hamamelis, all of which bring down swelling and internal bleeding.
Put on finger, apply to bum. Clench teeth for a minute, sigh with relief :o

Lovemelillady · 15/05/2011 09:43

Hi,

Has anyone here had skin tags removed from their ass? I has horrendous piles when pregnant with dd, and the result of them healing are skintags. They're sore, swollen and hurt nearly all the time at the moment. I desperately want to have them sorted out but GP says if I'm not done having babies I can't have them off. How do I know if I'm done having babies? At present, no I don't want another, but all those what if's swimming around are preventing me from having a poo in peace!

Any herbal remedies/homeopathy/self help??

ty

TheWestCoastLotus · 16/05/2011 21:41

I was offered banding of my haemorrhoids but ended up not having it done because it turned out my symptoms were due to a fissure rather than haemorrhoids.

Re self-help - I found none of the medically prescribed ointments and suppositories helped. I used witch hazel pads, kept in the fridge, to shrink them. If they were bleeding, i had to keep my poo mega-soft, and then wiped with aloe vera gel or vitamin E gel.

And then I name-changed and did a thread called "Hi, my name is oimyarsehurts and I need help" about my fissure and got some brilliant advice, maybe if you do a similar thread re your tags, you might get some helpful answers?

Cyee · 05/06/2011 22:11

Hi all,
Any news? How are you all?
:)

DMCT · 14/06/2011 22:31

HI Cyee, and everyone else. It has been such a long time since I've posted. All is good here, ........wait for it, I am having very pleasurable sex again..... Never thought I would. For those of you who dont know - I had a fourth degree tear with my first child resulting in bowel incontinence and bad tearing and disfiguring of the vagina areas...... After secondary repair 5 months post birth , i am now more or less back on track ..... 3 years later....... counselling inc - it worked even though im so not big into counselling.. Never going to venture as far as another child, i have one - im lucky, and im not going to sacrifice my body for another.. things still tender, but ok. Regards to all . dx

OldGreyMare · 23/06/2011 06:50

Hello! I've been reading this and the other thread for over a month but never had time to post, I don't really have time now either. I wrote a really long post yesterday but accidentally deleted it so I'll write that out some other day. I drank nulytly earlier today because I'm having a transpireneal fistula repair and sphincteroplasty in the morning. I had a failed repair in january this year and I'm really hoping this time it works! I've got to get to bed but I wanted to say hello and I'm thankful for all the info you ladies have posted!

SurelyNotMe · 24/06/2011 14:11

Hi Ladies,

I have been pointed in your direction and would really like to join this thread if you'll have me!. I've posted my story here if any of you have chance to read it. In brief, prolapse and some other issues.

www.mumsnet.com/Talk/childbirth/1244362-Prolapse-absolutely-devastated?msgid=26083421#26083421

I'd be really interested to hear some positive outcomes from a prolapse, and also how you all manage to cope. My confidence has been wrecked and I feel so disgusting. I really want to enjoy this time with my lovely young family but am really struggling and spend a lot of my days (and nights) in tears. I think it's a build up of a lot of problems from the start of the pregnancy.

I'm going to try and read the whole thread tonight. It's obviously horrible what has happened to us all, but I am glad I'm not alone.

bumpology · 30/06/2011 19:35

Hi, I wonder if I can join this thread too.

I'm just out of surgery for a second repair to a perianal fistula, which occurred after a second degree tear when giving birth to my daughter 10 months ago.

Basically my original tear got infected and resulted in a fistula forming between the perineum and anus. I had surgery on that, and it was all getting better, and then I developed another abscess in the wound, which ate its way through the sphincter muscle, resulting in another fistula - only it's worse this time because of the muscle damage. Plus the surgeon had to cut through some muscle fibres in order to repair the fistula.

So I'm feeling pretty fed up, and am so glad to find this support forum and to realise that I'm not the only one going through all of this - I've lost count of the number of times I've googled "perianal fistula" and "childbirth" and not come across any useful information!

What I find so shocking is that unless you talk about it, there is this complete veil of silence about childbirth-related injuries. I really wish someone had mentioned the possibility of problems in NCT classes, as at least I might not have felt like such a freak when it first happened.

Anyway, I wondered if anyone had any advice on how easy to take it while waiting for the fistula surgery to heal (mine has been "laid open" - basically re-cutting through the perineum and into the anus and scraping out the affected tissue). I'm not exercising, but it is difficult to rest up when you have a 10 month old scampering around under your feet all day.

Also is it likely that this will be it now, or should I be prepared for the possibility that this won't go away and will continue to plague me for years to come. It's just so emotionally hard to cope with, isn't it?!

bumpology · 30/06/2011 19:47

I've just been reading some of the earlier messages, and wanted to say that I also had a very painful fissure and got prescribed some "Anoheal" (great name!) by my consultant, which really helped. It's basically a topical blood pressure drug (diltiazem), which you smear onto the fissure and it increases blood flow to the sphincter muscle, speeding repair.

Jacksmania · 01/07/2011 15:35

PMSL @ "Anoheal" - what a name!!!

I'd been given that for my fissure, I don't think I found it helped.

Welcome bumpology - your story sounds awful :(
Will come back this afternoon (different time zone to you) and re-read properly. I'm so sorry this has happened to you.

l4k · 01/07/2011 16:41

Hi all,not very good at updating but was wondering if any of you have had experience of difference of surgical opinion while waiting for surgery?
I have decided I want an operation to try to repair the damage to my pelvic floor,rectocele and cystocele as the symptoms are gradually worsening but the 6 or 7 gp's gynes and urogynes I've seen can't agree on wether its best to have a vaginal hysterectomy at the same time or wait until its unavoidable.
They agree its a grade 1 uterine prolapse but dissagree on how long it will be before am back begging for hyster if they leave it now.(guesses range from few years to 10 years) I am 38,dont want any more kids.
I just wish this was all over.I am suffering with heavy painfull periods(to the point where my whole undercarriage has been aching and throbbing for about 4 days now and cos I stood for a long time at sports day yesterday I even had to get up and take nurofen last night cos couldnt sleep) but I think that should improve with just the repairs , do you think?
Oh, and had an internal scan the other week where it took 45 mins to locate right ovary as its stuck to my pelvic side wall near my pubic bone and the left one is stuck to pelvic side wall behind my uterus.Nothing is ever simple,is it?
This thread is proof of that!
Thanks for any advice.

Jacksmania · 02/07/2011 15:50

Hi 14K --- :( for you, that sounds awful.

I can't help you with the original question, whether anyone's had a difference of surgical opinion.

And I don't know if what I'm about to post is going to help you or confuse you further.

On the one hand, you don't want any more children, so your uterus technically doesn't serve you. If they're planning on leaving you your ovaries, you could as well have a hysterectomy while they're in there, because it will definitely give you better results for repairing the cystocoele and rectocoele. The weight of the uterus hanging on the suspensory ligament is not insignificant, and it could prolapse again. So, one thought is, while they're in there...

On the other hand, I have lately come across some research which says that the uterus and ovaries have a complicated interdependent relationship with respect to blood supply, and that there have been enough cases to report in the literature where someone has had a hysterectomy only, with ovaries left in, and the ovaries ended up failing within 5 years, which of course means menopause.
I asked a friend who is a naturopathic physician about this, and she said that she had read case studies about this and if someone came to her who'd had a hysterectomy she would give them small doses of bioidentical hormones (like progesterone cream, or even a combination of oestrogen/progesterone) to delay ovarian failure.

The thing is, this doesn't seem to always happen. And the issue is further confused by the fact that a lot of women who have hysterectomies are in the age group that could expect onset of menopause within 5 years anyway. So there is no clear-cut answer.

But you're 38, and onset of menopause at 43 would be quite early, so I'd ask about the risks of this. Be prepared that you may be laughed at :(, this link might help. Or you can Google "ovarian failure after hysterectomy". I have access to some online medical journals, when I get a moment, I'll see if they have anything to add.

Another thing is that whatever surgical procedure you end up agreeing on with your surgeons, there is the possibility that they may get in there and find that they cannot do the repair without taking out your uterus. And if they have to take out your uterus, they may have to take that one ovary that's stuck to it, as well.

Ask whether that's a surgical possibility. If they say it isn't, I'm sorry, but they're fibbing. You can't tell everything about someone's internal anatomy with anything less than a detailed MRI scan or exploratory laparascopy (belly button surgery).So if they'r telling you they can tell everything they need to from a sonogram, then they have better sonography than we have here. Which may be the case, I don't know.

Just to tell you my professional qualifications: I was a nurse (millions of years ago) and then switched gears and became a chiropractor, with a subspecialty in diagnostic imaging. Since DS's birth I've also done a lot of research of my own into women's health issues. So while I may occasionally be full of crap :o, I'm not full of crap all the time :o

l4k · 02/07/2011 20:04

jacksmania-thank you.My last opinion was from someone who is supposed to be one of the best urogyne surgeons in the country.She said definately hysterectomy.She has a poor bedside manner but when I was looking at private,she was recomended to me again and again if I did go NHS.Also,when I raised my fears at the scan appointment with 2 docs on her team,about the pelvic adhesions,they said she can still preform this surgery vaginally where others couldn't.
yes,I've been told that about the ovaries failing in 5 years.Not good but I think I'm heading that way anyway,mum and sister started meno in early 40's.
crying child,must go-but thanks

NurseSunshine · 02/07/2011 21:11

Hi everyone,

I've just posted my own thread asking for advice and somebody kindly sent me here.

My lovely baby was born a week ago by forceps. I had an epidural, she was 10lb 5oz and her shoulder got stuck, and then my contractions stopped so there was panic and when another contraction came it was like, right we need to get her out NOW and they really ragged her out. They gave me an episotomy which then tore further and I got a 3rd degree tear and lost 1500mls of blood.
I've since been having problems identifying when my bladder is full and also with holding in urine. I won't realise I need to go but then when I stand up I will leak. I'm having to wear tena lady pads :( I've seen the physio and am doing the excercises she recommended. I know it's early days but I'm only 23 and am just terrified I'm going to be incontinent for the rest of my life. (I don't mean that to sound as though, if I were any older it'd be OK, this is terrifying and distressing for anyone at any age)

I feel so lucky that my baby is OK as they had to take her off and resusitate her and I'm so thankful that the only damage done is to me. But I also don't know how I would cope if I end up incontinent, I'm a student nurse, how could I work? My baby's father left when I was pregnant, how could I begin a relationship with someone new, having to tell them that.
After everything, I honestly feel that I never want to get pregnant again, if I was offered a hysterectomy tomorrow there's a really good chance that I'd take it.

Gah, anyway that's me. I have nothing but admiration for all of you on here
:(

Jacksmania · 03/07/2011 17:28

Oh honey - I could have written your exact post three and a half years ago when Jack was born. Very, very similar. I had an epidural, and his head was stuck crooked, but he was much smaller than your your lovely little chubs :), only 7 lbs 7 oz. Regardless, yanking him out with forceps after I'd pushed for four hours did the same kind of damage. Third degree tear (one surgeon afterwards queried wether it wasn't approaching a fourth degree tear, but then he said what did the numbers matter, the damage was horrific :(), massive blood loss requiring transfusion. Altogether a completely shit experience.

I'm so sorry this happened to you. Personally I believe they should outlaw forceps. There has to be a better way. But before I start on my rant about how IMO a birth that's clearly going pear-shaped should not be allowed to continue until both mother and baby are distressed, that we have the option of surgical intervention and, no, it should not be exercised arbitrarily, but neither should it be withheld until a situation is ridiculously compromised... umm, well, there I go ranting again BlushGrin...

Ok, so back to you - from my experience, I would say at a week post-birth, your situation looks very hopeful. I had the same issue with urinary incontinence. Absolutely couldn't tell if my bladder was full, empty or at the half-way mark. Bladder? What bladder? I may as well not have had one for all I felt the damn thing. But the feeling does come back. Especially since you're so young and otherwise, I hope, healthy? I'm not saying that in a "pat, pat, there, there" kind of way - you have a huge advantage being 23. I was nearly 39 when I had Jack and there is a world of difference in the healing abilities of a 23-year-old vs a 39-year-old. And - this was never anything I thought to ask about, and god, I have a crap-load of medical eduction - women who've had lovely normal births, 9 hour labours, no tearing, have that "where the hell is my bladder" feeling! So... what I think is happening is that your nerves are shocked, especially the pudendal nerves which sit right inside the pointy pelvic bones that baby has to pass by (the ischial spines). If baby has a big head (and I imagine a ten-pounder would) and you had shoulder dystocia, then one or the other pudendal nerve would have been compressed between the head and the ischial spine, and taken a real beating. Possibly both. And from the trauma of the tear and subsequent repair, all your tissues down below will still be swollen which further compromises nerve supply.
It will come back. You may have to be very patient, but it will come back. I had what my GP calls "urge incontinence" for a very long time. It's not like stress incontinence where you leak when you cough, I never had that. Urge incontinence is when you have to go, and at the last second, you can't quite hold it, you literally either lose a few drops or start weeing as soon as your bum is lowering towards the toilet.

It's a good idea to do your pelvic floor exercises, but remember that your tissues are still healing. In my profession, we frequently disagree with physios because they push exercise as soon as possible, and I think that you need to support healing before you can exercise. But that's a professional disagreement and there is validity to both points of view.
What I'm trying to say is, even if your PFEs aren't too successful right now, they're helping you identify what feeling you do have and where, in other words, how your body feels now, after this trauma. So when the feeling comes back, you'll be in a better position to properly strengthen those muscles because you'll know where they are! :)

(((((HUG))))) - what an awful experience and what a shit way to begin motherhood. I think any of us who have had traumatic injuries during a birth are completely entitled to feel ripped off because that's so not how you think it's going to be. We all anticipate feeling tired, a bit sore, overwhelmed and a bit scared of the responsibility of taking care of this new life, but nobody expects to be doing it feeling like they've been bayonetted down below, and dealing with the fall-out of a very bad physical injury.
I've had some utter caaaaahs tell me "well, it's all part of childbirth", and I'm sorry but no, it's not. Nobody would expect a new mother to be up and around and fully functional if, say, she'd just had shoulder or knee surgery or been hit and broken a couple of ribs. Just because the injury is to a mostly-unmentionable place, doesn't mean it's any less incapacitating.

Holy cow, I must be in a ranty mood this weekend - that's two massive posts in two days!! What's gotten into me???