Health Organization for Pudendal Education

Thanks, Violet. As I'm probably facing the possibility of having to have mesh as my rectocele is pretty big (although I did read somewhere that mesh is usually only used here in the UK when a first attempt at repair with just stitches has failed) I shall do a lot of research. (I was reading that when mesh fails they often have to do a repair with a skin graft, which also sounds pretty grim, with potential for pn problems.) I'll post about it once I've learned more - just in case my research might help other people in my situation.

Dusty

Well, if the rectocele is so bad that it interferes with your ability to have BM's you may have to have it repaired at some point although I have sometimes wondered if a colostomy might be better than risking worse PN pain from a pelvic floor repair. It's a difficult place to be in.

Violet

Those were exactly my thoughts, Violet. I wonder if surgeons would do that though...When they haven't experienced pn themselves I'm thinking that they'd probably just view me as some kind of mad woman, as people usually beg surgeons not to give them a colostomy, don't they?...but we'll see.

Violet,

You said in previous posting:

Some of the gals on this forum had their PN problems start after pelvic floor repairs..

To your knowledge have any of those gals had any improvement with their pn over time without pn surgery or neurostimulation - perhaps with purely the help of pain meds for a time? (I guess an irritated nerve might gradually improve, but I was wondering whether improvement is at all possible when the nerve is cut and/or otherwise damaged accidentally, e.g. during pelvic floor surgery. I've heard that nerves can regenerate and also that they can die and elsewhere I've read that they take a long time to heal - but I wonder if it is only when they are purely irritated that there's scope for healing, and what is likely to happen with regard to a so called 'stretched' nerve outcome-wise, i.e. can it heal? Am a bit confused )

Thanks in advance for any light you can throw on this for me. (Whether or not have a rectocele repair is going to be a big decision for me, that's for sure )

Dusty

Dusty, each person's story varies. I know one gal who had pelvic floor repairs and PNE surgery did not help her. She now uses a neurostimulator that helps quite a bit. Another person actually had a stitch through the nerve during pelvic floor surgery. After having the stitch removed, she improved.

There is really no way to predict how much healing can occur but I would never say never when it comes to healing. Peripheral nerves do regenerate to a point but it may be wallerian regeneration and it may not come back exactly normal. Or a neuroma may form. It's hard to predict.
Having a plan and a positive attitude are a good place to start. You can always hope for the best. Keeping busy and keeping your mind occupied is another good strategy. And starting with conservative measures is typically what is recommended by most providers.

Violet

Thanks for that, Violet. (You've taught me something new, i.e. about wallarian regeneration.)

'Minefield' and 'pot luck' re choices and possible outcomes come to mind re my situation...

However, I think you're right about having a plan and a positive attitude....Trouble is I don't really have a plan as such at present; it's hard to form one when you don't like the sound of any of the options that you've read about But maybe something will come out of left field when I see the surgeon - an option that I'll find to be more acceptable to me....

At the moment I'm experimenting with stool softeners and different types of fibre etc., in the hope that I'll be able to manage with my rectocele for longer, before going under the knife.

Dusty

Dusty, I hope I haven't given the impression that living with prolapses is easy because it's not. You are right the options are not perfect but if you can keep your pain levels down without having surgery and manage BM's with laxatives that might be worth trying. When I had my annual physical recently the physician said I was smart not to have repairs done because there are so many women have new problems afterwards. But then there are women who do well after surgery and there is always that glimmer of hope, thinking you will be one of them....so it is such a tough decision.

Violet

Hi Violet

I didn't think that you gave the impression that living with prolapses is easy. I just tend to be gloomy with regard to outcomes as my body is so sensitive - it reacts adversely to drugs and other treatments that most people have little or no problems with. But, that said, I have had some surgery before - on one of my breasts for a benign but problematic condition - and that eventually worked out okay, so I shall try to remember that - if I have to have an op to repair my rectocele (along with anything else that might have also dropped).

Like you though, I'm going to try everything not to have any pelvic floor ops...Will see if I think that a pessary might help (doubtful though as I understand that they work less well for rectoceles, especially if the rectocele is low) and I would only opt for the kind of pessary that I can take out myself if I need to (as I don't want to have to go to the Accident and Emergency Dept and beg them to have it removed if it's causing me pain - because I can't get a clinic appointment for several weeks on our National Health Service here in the UK).

I've just read a posting on another forum about peristeen bowel irrigation being use to aid evacuation in rectocele patients which seems time consuming, but interesting/promising https://wholewoman.com/forum/node/2170

Also, with regard to surgery, I'm looking into the pros and cons of transrectal repair of rectoceles using the obliterative suture technique (involves no mesh as far as I can make out) http://www.researchgate.net/publication ... ive_suture

However, if I manage to avoid surgery until I'm older - and I think it likely that I will never want to have sex again - there's obliterative surgery instead of reconstructive surgery, which seems to be generally relatively pretty successful (and also seemingly doesn't involve any mesh) http://www.uptodate.com/contents/pelvic ... lpocleisis

(I've posted the above links just in case it helps anyone else searching around for ideas and possible solutions - as I remember you said that you don't have a rectocele, Violet.)

Time now to lie down in a darkened room (my head spins with all of my investigations )....

Dusty

Thanks for posting this Dusty. If mine ever develops into a rectocele I will definitely try irrigation rather than going for surgery. If you try it I would be interested to hear how it works for you.

Violet

I will definitely let you know, Violet. (I'm hoping that peristeen has now become more widely used for rectoceles in our National Health Service, i.e. since Pamela posted about it in 2008 and said that it was only available at two hospitals in the UK...I will buy one if necessary though - if the cost isn't prohibitive.)