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.

oldgreymare congrats on ur success in ur surgery, how did u seek out ur surgeons?? what question do u as?? what advice can u give me thanks

It states 50 60% success of spincter muscle control in my notes what do u all think of this ladies thanks

How do they define success?

I am not cured, not by a long way. I won't ever be what I was before the birth and the pain of the op took a long, long time for me to heal from because the collagen injections leaked into my vagina.

However, I am so glad I did it. I still have urge incontinence so if I have to go, I have to go! But things aren't in the same rush. It's not quite that I have control, I just don't have accidents. For me it's a success.

I'm just wondering if anything the op does will improve things for you? Or does it mean 50:50 as to whether you'll have the surgery and go on to have a bag?

I'll probably need a bag in my 50s. I don't think about it a lot now, if I did it would worry me. I can understand the fear of having that x

kellyketttle,
I gasped at the thought of the botex leaking what was it injected for?? that is terrible and yes it is 50 50 on needing the bag for good.

I have read the whole thread lol it took a v long time and nobody else has a bag for the repair I have searched the internet for months and I have not come across anyone gettin a bag which as really frightened me.

Im glad I have my notes which contained , lies like wtf u cannot b in labour then the next minute the forcepts are being used I only pused for 40 mins pushing well the the pushing after that was ineffective so I guess they had 20 mins to tell me so?? then the hour b4 was waitin on pain relief etc so I was there 2 hours in total.

It is noted I was unco-operative throughout the delivery I asked to go to labour ward as the mw with me was so horrible I wanted to get away from her and get proper pain relief at one point I was going to ask for another mw but did not want to cause a seen.

I had been to the hosptial 12 hours b4 that because I was in agony ds had to waken at 2am as my Aunt had let me down an I was sent home then we went again 12 hours later, at the last minute we asked my sister-in-law to mind ds it was 3pm then school was finished for the day and she took him to him.

If she was not free from work ds would of had to go to the hosptial with us we have no family

Im sittin here v numb sinking further and further into a dark deep hole and im scared I may never come out lets hope therapy will catch it on time take care

Thinking of everyone

Soapy even if you were uncooperative you still deserved to be treated with dignity. And not to cooperate for that matter, your body, your labour, your choice.

I didn't have Botox I had collagen - like the boob implant material but injected in liquid-ish form into my internal anal sphincter. It was to pad out my non-existent, unrepaired muscle to slow incontinence and improve flatus control. It helped but the collagen needs to "set". They put loads into my bum and I have a big strip of it running downwards towards my perineum and another that sits against my tail bone, again running towards the floor. The front one, I think, leaked into my vagina before it set leaving me with a lump in there which was painful when sitting, sex, having a period (tampons were a no-no). The bit at my coccyx would rub on the bone during long journeys, sitting at work etc. V painful but it seems to have settled.

There is someone else who posted on MN (but not this thread) about having a bag for months for a repair. Did you read the last thread? I'll see if I can find it but I have an antenatal class this morning and have things to get ready now.

Will come back this afternoon.

I'm on my laptop today! I never have time so I'm usually using the tiny screen on my iPhone.

Soapy - there was another forum that I visited to read stories. I found it a couple of days after my surgery. I'm not sure if posting links is allowed... but it was healthboards.com search for sphincteroplasty. The threads I read were "I survived Sphincterplasty (1-13)" There was really a lot of great information on there about other womens experience with the same surgery. Also I think that was where I read about other women who had to have a colostomy. But it may have been steadyhealth.com Wish I could remember. Has your surgeon done an anal ultrasound, mamometry, and Pudendal nerve tests? They can't really know the extent of the damage til they do some testing.

Kelly - The "leaking" thing sounds awful. I once had steriods injected into my scalp to get my hair to grow back and it also "settled" at the nape of my neck. I had a huge lump there for a day or two. I think collagen sounds much worse :/

I consider my surgery a success so far and even though I never want to experience that much pain again, I just had to do it! I'm 29 and I couldn't stand the thought of being incontinent the rest of my life. Falling asleep at the keyboard so I will try to check back tomorrow.
Hope everyone is as well as can be.

oldgreymare and kellykettle

I read the healthboard thread never came accross anyone gettin a else getttin a bag I even joined it but it closed after I joined in on the thread

No tests were done just my anal spincter is completely is there more to find out?

kellykettle

I did read all the threads must could of missed the one about the bag

Im really scared about the bag

www.mumsnet.com/Talk/childbirth/110680-anyone-had-a-4th-degree-tear-and-a-colostomy

Here.

I will pop back for other posts later x

has anyone here every torn upwards towards the clitoris? I have had to have my labia removed totally on one side up to the clitois, and 3/4 on the other and most of clitoral hood. from my baby in 2001. The opp was a few years back now but i still feel a bit of a freak to be honnest. It's been lights out in the bedroom ever since.

soapy - found the thread. There are several women who had them. They're old threads but you can read them and see how these women did. As far as healthboards.com they prefer you to start your own thread, they don't allow threads like this one where we can all support each other.
www.steadyhealth.com/Recto_Vaginal_Fistulas___Part_4_t202024.html?page=3

cattjojo - I didn't tear upwards, but my dr took my left labia to use as repair material. He placed it between my rectum and vagina. I'm lopsided now. It doesn't really bother me yet but I'm far from being healed enough to have sex so don't know if I'll feel differently down the road. He sliced it off with a laser so it stung for a couple of days and hasn't really hurt since. That whole area is still swollen and aches constantly still.

I'm hoping that it's just because I'm on antibiotics right now but I had an accident earlier today :( trying to think positively and I know I'm not done healing but it was so nice to not have that problem anymore!

How do I search many surgeons for spincterplasty btw im new to a computer im wanting to find the best success rates for this surgery with belfast surgeons

Can anybody please help??? im desperate thanks

Thanks kellykettle will post tomorrow

Hi kellykettle how r u these days??

This thread is really good and very helpful

I have a question when u have a episitomy are you not supposed to be check out after?

How did the Dr who delivered my baby leave me in such a state

Even the mw did not see my stitches came out what kind of a hosptial is that who has left mentally and physically torn thanks ladies

posted on the other thread, but wondered if this might be more appropriate?

hi there, not had chance to read this thread yet but hoping some people may be able to offer support/advice. I had my DD over a year ago, and tore quite badly at the time, although it was only classed as 2nd degree tears, it took hours to stitch up and resulted in me having a major PPH. We've only tried to have sex once and it was really sore - it felt like there was not enough room, if that's not far TMI. (Sorry!). Tampax are also a bit uncomfortable and I feel like they work themselves out too, again as if there is no room.

I've been treated for another underlying health condition since having my baby and am just recovering from that, so have only been to my GP today about it. He has referred me to the hospital, but I'm wondering what the likely outcome is, does anyone know? I am guessing it is scar tissue but that is a guess, it feels like a big long bump internally, but I've not had a close look (!). I'm terrified about going to the hospital, it was so traumatic being stitched up, but I will have to do it somehow, particularly if we are ever to have a sex life ever again.

Hi ladies I was wondering could I end up with double incontience with spincterplasty.

Hi I just got a letter saying im refused therapy and an appointment with the stoma would be more suitable. Well I arranged that already we are going on Monday.

Welll the stoma nurse was not a the birth !!so this has happened and suck eggs so to speak now im really scared how will my marriage etc survive this with no therapy??? help!!!!!!!

I asked for help before things will get worse nobody is listening!!!

Hello ladies!

Happy - sorry I have no experience with that so I can't offer advice. Hopefully someone on here can help you.

Soapy - that's awful. They can't refuse therapy here. I dont know how your health system works but is there any way around that?

Dd had an ear infection and a virus. She's had a bad fever for 4 days but it's finally gone. I have a kidney infection so I have more antibiotics but if they don't have me feeling better soon I have to go to the emergency room for intravenous antibiotics since I'm allergic to so many of them.
Saw my C-R surgeon Thursday and he prescribed lots of sex!! To help the tissue stay soft. I'm terrified! Seeing him in September after we've resumed relations (his words). I still have a rather large open wound...not sexy even if I felt up to it.

Hi all - am new to this thread. 33 wks pg. Had a 3c tear with DD, and have remaining defect to inner and outer sphincter. just wondering if anyone else has this and has gone on to have a vaginal birth. I am seeing consultant on Weds to discuss mode of delivery and really do not want a c-sec -but will have one if it really isn't safe to go vaginal.

does anyone have any perspective on this? From what I understand I will need another op once I've finished having kids but haven't discussed any further than that. Are there any good questions I should ask on Wed? TIA

ps have also posted on the other thread re: repairs etc.

Morning all!

Hi titfer. I had a 3c with DD1 and am 29 weeks pg with dc2 planning a vaginal birth at home with consultant support.

Like you, I also have ongoing defects though this is in my internal sphincter only which wasn't repaired at all (missed) but my external sphincter is deemed to have healed well (although I have slight risk of prolapse apparently).

Everything I read supported a vaginal birth following a 3rd degree tear. My consultant (obst) even said she is ok with it following a 3rd but not really a 4th.

My colorectal surgeon's view is that if you have defects now which will need repair anyway or if you have ongoing problems then its easier to support a vaginal birth. It's women who heal very well after the tear who may want to opt for ELCS to avoid tearing it.

Having said that, tears through muscles in the pelvic floor tend to worsen with age (post-menopause, lack of oestrogen) and an ELCS is not without risks or downsides - I did read a study which said an ELCS did not prevent problems worsening and also carried the risk of urinary incontinence (not sure why though).

Apparently the weight of carrying a baby will weaken our pelvic floor further and this is likely to be the cause of worsening problems.

And having said all of that, it is perfectly fine to opt for an ELCS if you want it or if you just cant face the worry of vaginal birth after a tear.

I would say that if you are going for vaginal birth you probably should try to avoid intervention as much as possible. Epidural slackens the pelvic floor, making it more difficult for babies to rotate and come out, puts you on your back etc and increases your chances of episiotomy/forceps etc.

Your risk of a repeat tear is 5-7%. My consultant reminded me last week that most women do not tear again to the extent they did last time.

Oh and my friend who has 2 CS and no vaginal births has faecal urge incontinence - when she has to go, she has to go.

I shall find some links to studies and post ASAP.

uws.clients.squiz.net/__data/assets/pdf_file/0010/86563/Does_elective_caesarean_section_prevent_incontinence_and_prolapse.pdf Section on Faecal incontinence comes towards the end.

The other links are saved on my pc at home. I am away at the moment but will post them later in the week.

Good luck

happy it's hard to say what the outcome will be at the hospital. I suspect they will want to have a look and examine you. Have you had any therapy from a women's health physio?

I had a lot of scar tissue from my episiotomy which was stitched too tightly and I was left with granular tissue. They just prescribed some cream to rub on it. It did take 18 months before sex wasn't painful but I think some of this was to do with fear for me. I also imagined that my vagina was ugly and scarred and it was only when I went for my smear test and mentioned it to my GP and she told me it looked normal that I started to get over it.

If you haven't had any treatment with a women's health physio then I suspect that will be your next stop and a lot of people get great results through that.

Oldgrey I am at your being told to have lots of sex to loosen things up. Christ. Sex shouldn't be a medical treatment, it should be enjoyable. If it causes pain then how is that helpful to your sexlife?

I was referred to a psycho-sexual counsellor who said I was incorrectly referred in a way because I didn't have problems in my head about sex, my issues were very real and what I need was trauma counselling. But as she was a sexual therapy counsellor too she prescribed some dilators for me. They are quite small, plastic, tampon shaped things and you just insert them, increasing the size over the weeks to gently stretch things. I think I picked them up from My GP so you could go back and ask about that. For use with lubrication but not as scary as I have probably made them sound.

I also massaged my scar tissue in the shower with olive oil (as recommended by a midwife). I don't know which "treatment" helped but once I started them both, things improved very quickly (I think about a week or two even).

soapy sorry I missed your post. Where are you? They cannot refuse you therapy - surely? Are you in the UK? Under the NHS?

What about any counselling services through work? My employer has an agreement in place to pay for X sessions of counselling for employees for whatever reason (they don't get told). Private health insurance?

You really shouldn't have to go down that route though.

Thanks Kelly. Gosh it's like the unspoken effects of childbirth, isn't it? No-one in real life seems to talk about this kind of thing.

I've only just seen the GP so no physio as yet, just waiting for hospital referral. I'm terrified TBH, the thought of being examined is just horrible, and brings all the memories of being stitched up back. I had a lot of other things go wrong and have also had another (unrelated) medical condition that has been horrendous the past year, I'm just recovering from surgery for that.

It would be great if it was just a cream.

I hope the rest of all your pregnancies go well, and you get the births you want. It is really amazing to see that you are pregnant again despite everything, it gives me hope. At the minute I would gladly never have sex again, nto very fair on my DH I know.

Oh happy, I have posted on this thread since the start under several names and I think I said all of what you said in some way or another.

I remember DH and I both crying when I said I never wanted to have sex with anyone ever again. He heard "I don't love you". It was so hard for a long time. I couldn't explain how painful or frightening it was or how being touched anywhere near my vagina reminded me of the birth. It was like we were speaking different languages all the time.

Counselling helped, time helped, having someone tell me that what happened to me shouldn't have happened (I recall having a MW & a consultant examine me vaginally at the same time in labour - training for MW. I wasn't asked permission and found it humiliating and upsetting).

I would recommend the massage if you can face doing it. My therapist also suggested I examine my vagina with a mirror to see that it wasn't horrible but I couldn't do that. I can look at the scars to my perineum now though and that's not upsetting anymore.

I also said that we'd never have more children. I wasn't scared of birth - they had already said I could have an ELCS - I was scared of sex and intimacy. Not just the physical act of sex but the closeness. I couldn't kiss or cuddle DH for months.

Now our sex life is the best it's ever been, truly. We've been together for 8 years and for some reason it's better now. DH would like it more but he works away and I have no sex drive in pregnancy but we do have sex it's more relaxed and comfortable than it ever was. We didn't even finish the counselling (moved house) so I have no idea why.

And I am enjoying this pregnancy more because I feel like I have fewer worries. My worst fear with DD's birth was a tear, you read about it and it just sounds horrific doesn't it? But it happened and I survived and life is good. If it happens again I will be upset but I know now that there is light at the end of the tunnel. It can just be a bit hard to see for all the twists and turns sometimes

Do you have any breathing techniques to help with the examinations at the hospital? I still cry after leaving every gynae/colorectal appointment. I find hospitals very upsetting now. But for exams I tend to close my eyes, no chatting and just breath very slowly.

You're right, no one talks about it but I decided to confide in a few friends and family and since then I have become the person to talk to about tears and prolapse! My friend called me last week for advice for another friend and a colleague told me that she has urge incontinence post 4th degree tear. I think it can feel so isolating suffering like this and knowing someone out there understands makes a huge difference.

I toy with the idea of starting an online support group for it but I think this thread on MN is enough