PN caused by rectocele?

[Dusty_in_Hope]

Hi everyone,

I'm new to the forum, possible have pn, and am post-menopausal. I have had a rectocele for over 4 years. I was managing quite well, but I suddenly developed what I think is pn at a time when I think that my rectocele has now got bigger/worse. Surgery might be on the cards for my rectocele. I shall have to see what the surgeon says (I suspect that I might possibly have developed a cystocele too) and I'm terrified that it will make things even worse for me pain-wise. (To make matters worse I cannot tolerate oestrogen cream as it affects me systemically and makes my long-standing fibromyalgia muscle aches and pains considerably worse.)

Thanks in advance for any replies; I would be grateful to hear of anyone's experience of pn and rectocele and pelvic organ prolapse surgery.

Dusty

[Violet M]

Hi Dusty,

I have a severe cystocele and uterine prolapse for quite awhile but not a rectocele. Basically I manage it by wearing thigh shapers. I don't really think that for me it is related to the pain because I had it for awhile before the pain ever started. My pain developed soon after I started a weightlifting program.

There have been women who developed PN pain as a result of pelvic floor prolapse repair. I've considered pelvic floor prolapse repair in the past but my physicians discouraged me from having it done because of the PN pain and the possibility of making it worse, but if you have a severe rectocele there might not be any way around it. The way they explained it is that when they do a pelvic floor repair they have to pull the muscles tighter and that can irritate the nerve. I remember a former member of the forum named Calluna who had a pelvic floor repair and it actually helped her pain so you might want to search through her posts. Each person is different and it can be hard to predict how you will respond to a surgical procedure.

Violet

[Dusty_in_Hope]

Hi Violet

Many thanks for replying. I will definitely look up Calluna's past postings. It would be good to know if her successful surgery, which resulted in the reduction of pn pain, included a rectocele repair and what method they used to do her op - the thought of having to have mesh inserted with all the potential problems it could cause is terrifying me! I've been referred to a surgeon - who, thankfully, has a good reputation here in the England, UK - to explore what might be done. (As previously mentioned, I react badly to oestrogen cream though - so I don't know whether the walls of my vagina will stand up to the surgery as I'm post-menopausal.)

Since getting (what I believe to be) pn and my rectocele worsening, I've upped my fibre intake with Benefiber (on top of eating a lot of fruit and veg as part of my weight-reduction diet plan) to create the smoother passage of stools and I think I might manage with my rectocele as it is for, hopefully, a while longer as (so far) the extra fibre is helping a lot. But I think surgery might be inevitable as I age, what with being post-menopausal and my oestrogen levels probably getting lower and lower as time goes on.

How do the thigh shapers help you with your cystocele and uterine prolapse? (Sorry, if I'm being too personal and/or rather dense about this - I'd not heard of thigh shapers before and have only just googled them.)

Kind regards
Dusty

[Violet M]

Well, Dusty, if anyone thinks it's too much information they can stop reading, eh? If it helps someone else struggling with the same issues that is what matters.

Thigh shapers are made of stretchy fabric and if you get them a little tight, it helps support the pelvic structures and hold them in place. This picture is from the Spanx website.

pSPXNA-MS2744_VRYBL_main_v275.jpg (23.63 KiB) Viewed 4227 times

I have chosen to live with the slight discomfort of the prolapses, even though they are fairly severe, rather than risk having the pudendal neuralgia pain come back. It's really a matter of weighing the pros versus the cons.

Violet

[Dusty_in_Hope]

Hi Violet

Your philosophy about the 'too much information' aspect of things matches my own!

Thanks for posting a picture of the thigh shapers that you wear...The ones I saw when I googled them weren't a full 'knicker' - they just were like 'sleeves' around the thighs, which made me wonder how on earth they would help with your prolapses! lol

At present, what with my pn-like pain, I don't think I could stand anything as tight as that against my genitals, but I can see how those full 'knicker' thigh shapers would give good support (which I have often felt that I could do with for my rectocele).

It's interesting to read that you say that you have 'slight discomfort' from your severe prolapses as I had been wondering whether prolapses can ever cause as much pain as I am experiencing now....Before the pn-like pain came upon me, I only had mild discomfort from my rectocele - a bit of a heavy, dragging sensation (although I did experienced a lot of pain with it if I was ever even slightly constipated)....

I was reading elsewhere that with a rectocele prolapsing badly it can 'stretch' the pudendal nerve - and have thus been wondering if that's what might have happened to suddenly cause all this pain I'm now suddenly experiencing as I do think that my rectocele has recently got worse. Can stretching of the nerve ever be corrected with surgery do you know?

Thanks Violet,

Dusty

[Violet M]

Dusty, I had prolapses for many years before my PN showed up. I first noticed the prolapse problem in my late twenties after my second child was born. My physician told me it was most likely due to a genetic collagen deficiency so it's not primarily a muscle problem but a ligament issue where the ligaments are not holding things up. So really, all the kegals in the world are not going to fix the problem. The discomfort I've had from the prolapses is not pain but rather a dragging feeling like you described. My obgyn said she sees many women with prolapses who have no pain at all and she does not feel the stretch of the nerve due to prolapse is what causes pudendal neuralgia and at least in my case I agree with her.

The dragging feeling from the prolapses can be pretty annoying at times but most of the time I don't think about it. The thigh shapers come down far enough on the leg that they don't seem to bother the PN disbtribution area but have actually helped to stabilize the pelvic instability caused by strained ligaments.

Violet

[Dusty_in_Hope]

I have ligament issues too, Violet. I've had them since my early 20s, i.e. sacro-iliac instability on my right side causing lots of pain when my pelvis (often) skewed out of line. I investigated having sclerosant injections into the ligaments but - with my pelvis torquing with spasms associated with my fibromyalgia - I decided I couldn't take the risk. (I was told that the sacro-iliac ligaments get thicker and ropier with old age after the menopause and better stability can result from that and, fingers crossed, so far - despite muscle spasms associated with my fibromyalgia still affecting that area from time to time - I have faired much better since my mid 50s.) I was told that sacro-iliac ligament problems are suffered the most by pregnant women as the sacro-iliac ligaments slacken in preparation for the birth. (I've never been pregnant, so I think my ligament issues are also probably genetic, with a small tumble on the stairs in my house triggering the first signs of a problem back in my early 20s - plus my fibromyalgia syndrome also affects not only the muscles but the ligaments too.)

The thigh shapers come down far enough on the leg that they don't seem to bother the PN disbtribution area but have actually helped to stabilize the pelvic instability caused by strained ligaments.

In that case, I might try a pair of those.

What your obgyn advised about the stretching of the nerve not causing pn is somewhat heartening to me. I would like to avoid surgery for my rectocele if I can, so I will probably now be a little less fearful that leaving it be (if I can) will make my pn-like pain any worse. I will also see what my obgyn surgeon advises when I eventually get to see him; he's supposed to be approachable and 'pelvic pain' aware.

Thanks for all your input - I've been reading many of your postings on this forum and you are an absolute mine of information (gratefully received)

Dusty

[Violet M]

Dusty, I would be interested to hear what your gyn surgeon says. Some of the gals on this forum had their PN problems start after pelvic floor repairs -- especially with mesh, so definitely think twice about that.

Best,

Violet

[Dusty_in_Hope]

Hi Violet, Yes - I will certainly report back after I see him - or more likely I will see one of his 'team'. The referral's on the UK's NHS so I doubt whether I'll be able to see the big man himself, but I plan to have a consult with him privately if that does happen, as I want the best opinion I possibly can before I make any decision about surgery (even though his team are supposed to be excellent.) I'm terrified of having to have mesh and need to do some research about it - I read anecdotally that there is a form of mesh that 'dissolves'(?) and is less likely to cause problems. I'd be interested if you have heard anything about that at all.

Thanks,
Dusty

[Violet M]

Dusty,

I'm not an expert on mesh and haven't really researched it much. Dr. Hibner said that 80% of his practice is mesh removal so obviously it's a big problem for a lot of women.

Violet