bulging at the perineum?

Submitted by kiki on October 28, 2008 - 3:33pm
Body: 

Christine,

In another post you mention "The reality is you are much (the urogynecology literature states 500%) more likely to experience further prolapse symptoms, the most common being another rectocele – this time a very difficult bulging at the perineum;"

I'm curious about the bulging at the perineum, and how this manifests & progresses (well, maybe i don't want to know if that is indeed what i have...but i'll ask anyway!). I've always noticed that if my stools get too hard they bulge into the vagina, as everyone describes, but more recently as my rectocele has further improved so everything doesn't go inwards as much, they bulge around the perineum and i feel like i need to press there as i'm terribly prone to fissures, so this helps to move everything a bit more where it belongs. is that what you are describing?

if so, any more info on that would be helpful--and should i be worried?

thanks
Kiki

kiki

October 29, 2008 - 12:09am

thinking about this, it's as if the stools have the space to get bigger than the anal opening now, and thus i get the feeling they are pressing on the sides of the perineum around the anus (seems a bit more to one side...). maybe it's always done this, and i've never noticed as it doesn't affect me unless i'm have a fissure prone time / constipation which was never an issue till now. but i've lost sight of what's normal!

ah, the things we talk about here...thank goodness for WW!

Christine

October 29, 2008 - 1:12am

Hi Kiki,

I think the most useful concept we can keep in mind about the perineum is its ‘distensibility’. This trampoline-like quality is the result of how all the muscles and tendons of the pelvic interior anchor into the “central tendon”, or perineal body.

Yes, a perineocele can co-exist with a rectocele. What I was referring to is a situation where the back vaginal wall is surgically “strengthened” and perhaps fascial “defects” closed. The rectocele may be “repaired”, but now intraabdominal pressure distends the perineum unnaturally leading to a perineal bulge and need for splinting.

Kiki, this is all very manageable in whole women - even if we do have residual muscle injury from birthing. Some perineums are more bulgy than others. Maybe one year your bulge will be a little better here and a little worse there. Maybe eventually there will be improvement all around. What you need to understand is that the parameters for distensibility are huge. As long as you’re not causing undue pressure by straining against a toilet seat you can distend your backside as much as necessary with no worries of blowing anything out. These structures are not delicate and are only injured when confronted with things like toilet seats, birthing tables, and scalpels.

I would say make a cup of tea and relax.

:) Christine

P.S. I used to have trouble with fissures too, but that just never happens anymore. Do you eat much seaweed? I find it to be extremely soothing to the entire bowel.

kiki

October 29, 2008 - 10:53am

thank you for your wisdom and reassurance. it makes perfect sense as you say how our bodies do work as they are meant to. so thank you... I am (if you hadn't noticed!) rather anxiety prone, and do tend to worry the worst...not a good quality i know!

sea weed. i used to eat but it havent in ages. is there a particular type that's especially good? the fissures are related to my mystery itch, be it thrush or the LS. they come and go with the itch. it got very bad the last few weeks when i ate rather too much sugar, but cider vinegar helped about 50% and now trying garlic--and today only a tiny itch, so fingers crossed it is the thrush and i can find natural ways of dealing with it... but we'll see what happens as this cycle progresses.

so sea weed info please!

thank you as always,
Kiki

Christine

October 29, 2008 - 10:08pm

Kiki, I think it would be a really good exercise for you to see what seaweeds are available in the UK. They all have different properties, but their bowel-soothing micro minerals and gelatinous nature are common to all. Traditionally, the Brits ate lots of different “oarweeds”, such as dulse, bladderwrack, and Irish moss. I eat many different sea vegetables from Japan and the NE coast of the States. Nori is what they roll sushi in and can also be crumbled into soups or casseroles. Dulse is divine and great added to salads. I put pieces of kombu in pots of beans, eat salty wakame like popcorn and top pumpkin soup with a mound of hijiki, which looks like little, curly black sticks.

kiki

October 31, 2008 - 3:58pm

you never cease to amaze me!
i'll start looking and experiment
thank you!

Anonymous (not verified)

February 26, 2009 - 5:02pm

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