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Rectocele surgery

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Crohn's Disease
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huckleberry
Regular Member
Joined : Sep 2007
Posts : 338
Posted 6/17/2013 5:10 PM (GMT -7)
Hi everyone,

My CD has been pretty well controlled - but I've been having rectal and tailbone pain and incomplete BMs as well as bladder issues. My uro-gyn has recommended a simple bladder sling (TVT) for a small bladder prolapse and also a rectocele repair for a larger posterior prolapse. (Would also have endometrial ablation at same time.) She says that it's a night or two in the hospital and then a month or more at home in recovery.

She couldn't believe I hadn't come in sooner, but to be honest I thought the symptoms were CD related and planned to discuss them with my GI at my regular appointment in August.

I'm wondering if anyone has had this surgery for rectocele with a uro-gyn (vaginal incision) rather than a colo-rectal surgeon (usually a rectal incision). I like the doctor a lot but not sure if I should go another way because of the Crohn's.

Any experiences or advice to share? I'm willing to do it, but want to minimize complications and possibility of further surgery. Thanks in advance.
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huckleberry
Regular Member
Joined : Sep 2007
Posts : 338
Posted 6/24/2013 5:14 PM (GMT -7)
OK - no takers on this question, but I have an update.

Surgeon says that she thinks it's necessary to use a uro-gyn rather than colorectal surgeon because I'm also having the bladder and uterine work done. Makes sense I think.

I do wonder about complications (really don't want to mess with anything in my digestive tract) but she said she doesn't think it will affect the inside of my rectum at all and doesn't see a problem with the CD. She does think the recovery is not easy and I may have a catheter for several weeks at least. So..........

Anyone with experience with pelvic prolapse surgery, recovery and Crohn's? Any advice? Words of caution?

Just checking -
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scifigal2k
Veteran Member
Joined : May 2012
Posts : 3669
Posted 6/24/2013 7:55 PM (GMT -7)
Sorry no one has answered....I'd never heard of any of these surgeries before. But I'm sorry for what you're going through, and I wish you all the best with them! I hope they help and turn out well.
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huckleberry
Regular Member
Joined : Sep 2007
Posts : 338
Posted 6/25/2013 5:00 PM (GMT -7)
scifigal - thanks for the reply! I hadn't heard of these things either and I made the mistake of waiting a really long time to mention the issues to my doctor - assuming it was just another crohn's thing.

Now I'm a little nervous about complications in healing, etc. It sounds kind of awful. But, I hope to get my surgery date Monday, and then I can start to get ready.

Thanks again - hope you are well.
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Ides
Forum Moderator
Joined : Nov 2003
Posts : 7198
Posted 6/25/2013 6:41 PM (GMT -7)
lost internet connection. had this surgery. impossible to type from my phone. will post when I get a connection.
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scifigal2k
Veteran Member
Joined : May 2012
Posts : 3669
Posted 6/25/2013 7:52 PM (GMT -7)
I probably would have waited, too. I'm afraid my philosophy has turned into something along the lines of if I'm not bleeding a lot with over 20 BMs a day or my pain isn't over a 6, it's not worth mentioning. I'm doing pretty well, thanks. :) My husband and I are having our first baby in 3 weeks, so we're getting pretty excited.

Keep us posted on how you're doing! And I look forward to reading what Ides has to say after internet's restored. :)
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Ides
Forum Moderator
Joined : Nov 2003
Posts : 7198
Posted 6/25/2013 8:39 PM (GMT -7)
Huckleberry - This is what I attempted to post when we lost Internet connection in our area. Fortunately I saved it. And again, email me if you want to discuss this more:

I had complete pelvic floor reconstruction in December of 2010. They did the surgery vaginally. I had a prolapse of the bladder, a rectocele, and intestines prolapsing on top of those two. It was impossible to urinate without physically moving body parts out of the way, and the same thing with a BM. The prolapse occurred when I was in the hospital with hemorrhagic C. diff. The 7 weeks from the time of the prolapse to the surgery were awful.

A top rated URO-GYN surgeon did my surgery. I was in the hospital two nights though they would have liked me to stay longer. They do NOT make incisions in the rectum or intestines. It is just a matter of putting everything back into place.

Prior to the event in the hospital, I always blamed my difficulties passing a solid BM on my disease or hemorrhoids. Well, after the surgery, no problems going anymore. Yipeee!

I did have a complication, actually two, one requiring a second surgery. Neither of these were the result of anything the surgeon did or did not do. Feel free to email me if you want more info.
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huckleberry
Regular Member
Joined : Sep 2007
Posts : 338
Posted 6/26/2013 7:12 PM (GMT -7)
Ides - I cannot tell you how great your post makes me feel (even though you had further surgery). Thank you for responding. As you mentioned, I always attributed the problems with Crohn's - I'm just amazed to hear it's something else. I totally get your "yippee" comment...I hope that's me, too! I also have to do some manipulation to make things move - about half the time; not always.

Follow up surgeries are a concern since I hear there's a relatively high complication rate, but at this point I don't really have another choice - - how was the pain / recovery?

Am also relieved to hear that nothing else was touched - I'm using a good uro-gyn at an urban teaching hospital, so I'm hoping for similar good result.

Thank you for responding! I really appreciate it.
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Ides
Forum Moderator
Joined : Nov 2003
Posts : 7198
Posted 6/27/2013 5:02 PM (GMT -7)
The recovery was tough for me due to the fact I lost almost 50% of my blood volume and had transfusions but was still very anemic. That left we more weak. Also, the bleeding all went into my tissue [buttocks and thighs] making it nearly impossible to sit or lie on my back. I bled because of a previous pelvic surgery and my body had routed a vessel where it was not supposed to be. The pain was mostly from my massive bruising and the long time on the table messed with my already screwed up back.

I was not allowed to squat or lift anything over 5 pounds for 6 weeks. Also, no vacuuming. However, that might have been because my surgery required such extensive revisions.

My other complication came about 9 months later. I needed another surgery to close the top of the vaginal wall as it had eroded and left exposed mesh. This is the same mesh that the FDA has since put out a warning regarding. My issue was not the mesh but being allergic to the sutures and they had been rejected letting the opening to occur. This was the second time that I had rejected this type of suture and now carry a letter from the surgeon saying to never use it in me.

Hope this doesn't frighten you off. In spite of what happened, I am far better for having had the surgery. Getting normal function has made a big, positive difference in my life.
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huckleberry
Regular Member
Joined : Sep 2007
Posts : 338
Posted 6/27/2013 6:46 PM (GMT -7)
Ides,

Again, I can't tell you how much your reply helps me. The recovery sounds awful, but it speaks to how awful the prolapse is that you're so happy with the outcome, and I'm wanting to go forward despite the risks. (They are also telling me 6-8 weeks, no more than 5 pounds -- sitting will be difficult, etc.)

I'll find out more on Monday, including hopefully a surgery date. Will keep you posted. And, thank you again for sharing all this.
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huckleberry
Regular Member
Joined : Sep 2007
Posts : 338
Posted 7/1/2013 3:22 PM (GMT -7)
Just an update. Saw the doctor again today. Things seem a little less confusing. Going to have a bladder sling and also posterior prolapse repair with also some gyn surgery. Doctor now thinks it's not 6-8 week recovery, but more like 3-4 weeks out of work and a few more to feel fully better. So, that sounds more do-able. She did say that it's a painful recovery, manageable with meds. She doesn't see any reason that it will put me in a flare.

I still need to consult with gyn on the other parts of the surgery - and I am quite anemic right now so she doesn't want me to do the surgery in July - so now I know I've got awhile.

Even though this is (hard to believe) not related to Crohn's, I will post again to let you know how it's going. Thanks again for the support.
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Ides
Forum Moderator
Joined : Nov 2003
Posts : 7198
Posted 7/1/2013 9:28 PM (GMT -7)
Good news regarding the shorter recovery time! I have several other issues not related to Crohn's as I get older. Life and my body constantly surprise me. Keep us apprised regarding your surgery date.
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kvavoom
New Member
Joined : Jul 2013
Posts : 1
Posted 7/24/2013 11:02 AM (GMT -7)
By now you may have had this surgery but I will share with you. I had a severe rectal prolapse.

The rectocele repair was not as bad as I was expecting. Pain for only about two days, easily controlled with Narcotic pain meds. Those were the worst as they affect vision, mood, etc. I only needed Ibuprofen after day two with complete pain control. Days 4 and 5 were uncomfortable until I discovered the cause, hemorrhoids. So, if you also have hemorrhoids, see if the doc can take care of those at the same time as the surgery. By day seven I had forgotten I'd even had surgery. Day 14 I found myself running, with no discomfort....forced myself to stop and remember to try to pretend I was recovering. By then I was lifting and carrying on like nothing happened.

Take stool softeners for at least two weeks, watch out for Hemorrhoids, I could have gone back to work day 7. Now it's just boring waiting for my 6 week appointment to be released for all activity. I gained 5 pounds from inactivity.
Good Luck.
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huckleberry
Regular Member
Joined : Sep 2007
Posts : 338
Posted 7/27/2013 4:42 PM (GMT -7)
Kvavoom - thank you for the reply! Sorry it took me a few days to see it.

My surgery is toward the end of September - I'm trying to resolve anemia first. Going to have rectoele repair, bladder sling, hysteroscope, polypectomy and endometrial ablation. Two surgeons - a GYN and a URO-GYN. Such fun!

I haven't seen my GI yet, but have an appointment before the surgery just to make sure to get his input on healing and precautions.

But, it's great to hear it wasn't too bad for you. I'll watch out for the hemmies and I'll keep you posted.

Thanks everyone for the advice and support.
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gumby44
Veteran Member
Joined : Nov 2007
Posts : 4505
Posted 7/29/2013 3:17 PM (GMT -7)
Hi Huckleberry,
What are you doing for the anemia? I've never had any uro/gyn surgery so I can't help you there...just wanted to wish you good luck. I hope you are feeling ok while you are waiting until September!
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huckleberry
Regular Member
Joined : Sep 2007
Posts : 338
Posted 7/29/2013 6:45 PM (GMT -7)
Thanks Gumby,

I am slightly allergic to the iron infusion, so I'm taking a lot of Slow Fe, Vitamin C, eating beef and spinach and resting more than usual. :-) It's sort of a short-term solution just to get to the surgery.

I am working 3/4 time at work since the long days were too much - I kept blacking out, which was alarming to everyone.

If it gets worse, I can do the iron as an in-patient. My last labs were much better - except Ferritin is still only 3.

I spoke to my GI who is doubtful that all the bleeding is just GYN related. He wants to squeeze in a scope before the surgery...never a dull moment! (I keep going off the Pentasa so feeling guilty about that; will probably start again - the 16 pills a day was killing me.)

I hope your Wed appointment goes well.
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