Rectocele question

Hi Mellie

In my experience I used to have to splint almost every time at first, before I was even diagnosed. Now, over four years later I would only splint a few times a year. It is usually a combination of dehydration, low fibre diet and stress that causes it. It is often pre-menstrual. I can deal easily with the diet and the water. I know that the PMS will pass. For other stresses if is often a signal that I have to deal with it. Then it passes.

I have also learned a few different ways of re-positioning my rectum and other pelvic organs in between times (think inversion, nauli, firebreathing etc) and keeping them there (think posture). I have also learned to look for a toilet as soon as I feel the urge to empty. Different for a wee, when I try to hold on, then empty completely each time if I can.

Posture while pooing is also quite important.

As you can see it is a multi-cause problem with lots of solutions to use as much as possible.

Cheers

Louise

Hi Mellie

I have now read your initial post more carefully. As I understand it now, you splint every time, but the pocket of back vaginal wall that stuck out into the vagina before emptying hangs out of your vagina after a bowel movement, and you have to push it back inside the vagina. Once it is back inside the vagina does the back vaginal wall go back to normal?

Or do you mean that a bit of bowel comes outside your anus, and you have to push it back into your anus? No, I don't think so.

Have you tried nauli or firebreathing after a bowel movement, before you pull up your knickers? Or just stand up in posture with feet apart and then bend deeply forward from the hips and have a bit of a jiggle around. If you can get the sensation of air in the vagina that probably means that all your organs have moved 'up'. Then bear down just sufficiently to expel most of the air, then uncurl to upright again. This type of manoeuvre should suck everything back up again, which should flatten out the back vaginal wall by itself as the bowel moves up again. I have never experienced this problem.

An afterthought. I wonder if you are in fact emptying your rectum completely, or if there is in fact still some stool in there? The nerve signals for bowel fullness and emptying are quite complex. Many women seem to get crossed signals, eg, not empty but stool not moving, or full but contents not moving, or don't know if it is stool or wind.

I think you have to be a little careful when splinting. Don't strain. And don't push your thumb/finger too deep into the back vaginal wall, lest you cause more damage. On the other hand, maybe you are not pushing it back far enough to get the pouch back on the rectum side of the damaged fascia.

BTW, Mmm, what would we do without showers?

Louise

Hi Mellie

Well, the things we have all found out 'along the way' are no use to anyone else unless we share them, so ...

It sounds like you have a very large and definite rectocele. My thumb works OK for me for splinting. Maybe the area of hole you are dealing with needs something larger, like the backs of several fingers, but that makes splinting more of a performance. How long are your arms? ;-)

Hope the jiggling works.

Hey all you rectocele-bearing Wholewomen out there, has anyone else got anygems of wisdom to share with Mellie?

Cheers

Louise

I'm pretty new to the site and keep reading the wealth of really good information. I've a rectocele that I've been living with for a while. When it was smaller, I was coping, but after a recent colonoscopy, it immediately got far worse. I don't know what splinting is or jiggling and I'll try anything right now that might help. When I bear down my rectocele drops out of my vagina and I too have to put it back up. I also have lots of pain trying to start to go even with soft enough regular stools because when I push downward to go, the stool how it lies is larger has a tough time existing. When it comes out it comes out like a large bulbus kink or knuckle with a 90 degree turn that all came out at once. I need to find some way to make that better. It has been about a month since my colonoscopy and I've been back to that doctor and to a obgyn but without much help. The surgeon is not suggesting surgery and the obgyn says that I'm not that bad yet! despite the fact that I'm ripping myself so badly nearly each time I go. I've tried stool softeners, but I get the same thing but just with more bulk to pass. They make it worse.

I feel that I need to give squatting a try as angles and gravity may be more natural than the toilet for me. Any one going that way? I think I'll be more succesful I just have to figure out a method to achieve it on old knees!

Is there something anyone has found that I can insert to soothe the rectal area afterwards...jells or cream. I have bright red bleeding too. Afterwards my rectum seems like it opens so large that it is trying to turn itself inside out. Thanks...everyone is so supportive. Sara

Hi Sara

We have our own secret language on this site (no, not really!). But there are some shorthand terms that individual members have 'coined' or we have developed together, or found elsewhere, that are helpful in managing POPs ourselves.

Examples are:-
Splinting, ie using a finger or thumb, held in the vagina to push the kink out of the rectum, which pushes the stool into a straight line again, before expelling the stool. This kind of stabilises the posterior wall of the vagina and the damaged fascia that lies between, and supports,the rectum and the vagina. Then they don't get any more damaged or stretched when you empty the rectum. What you are talking about with the kink in the rectum is exactly the sort of symptoms that sent me off to the Gyno over four years ago. I now get that kink, maybe only 6 or 7 times a *year*. Initially I was having to splint most times I emptied my bowel, but it became less and less, and now hardly at all.

Jiggling, ie bending deeply forward from the hips with legs well apart, so that your spine is pointing downwards, your lumbar curve is still there and your belly is hanging loose. Then jiggle your legs around a bit, which jiggles your abdominal and pelvic organs around too, and kind of packs them neatly 'up' towards your diaphragm. Do this in private, as you might feel and/or hear some air go into your vagina. This is fine. It means that all the organs have moved and created a vacuum. Now bear down a tiny little bit to expel most of the air and unfurl like a fern leaf into Wholewoman posture (see FAQ's on the main website). Hopefully your rectocele will then be less or non-existent, even if only temporarily. It is giving your body the opportunity a few times a day to practise getting its pelvic organs into their proper spots (into their little fascia jackets).

Nauli, an advanced yoga move. This also produces a vacuum in the abdominal cavity which pulls the pelvic organs upwards and inwards. I haven't mastered nauli yet. You can find a video demo of nauli by searching it on YouTube.

Checkarama, the habit of checking your POPs many times a day. This can lead to a form of insanity which nobody outside Wholewoman understands. But we know all about it, cos we invented it!! The cure to this insanity is to only allow yourself to check once a week, so you can get on with your life. To check more often is just too distressing, and won't make your POPs evaporate.

There are probably other mysterious words and terms we use. Just ask if something puzzles you.

NB!! Please don't push the stool out by straining. Any straining while emptying your rectum has the potential to damage the fascia more and will contribute to anal fissures which produce the fresh blood. You may find it hard (sorry, difficult!) at first, but straining is one of the main causes of rectocele. It just puts more pressure on already-damaged tissues. Once your body gets the hang of it you will start to trust your body again. The stress will become less and you will probably have less problem with emptying your bowel. You just have to break the vicious cycle.

I guess your doctor is happy for you to keep straining so the rectocele will get worse and he will get another surgery customer. Doctors can be very wise, but they can be very ignorant as well. The trick is to know the difference!

A half squat with elbows resting on knees will probably be more effective for emptying than sitting on the toilet. You might find rocking backwards and forwards, flexing your lower spine and straightening it, might also help to shift the bowel contents along. Some women find that turning to the right while emptying also helps. That is because of the direction of the coiling of the lower part of the large intestine.

You can use the Search box at left to search for some of these things on the Forums. We have discussed them all at length before.

Hope this is some help. Happy pooing! ;-)

Louise

Just testing

I am 74 and a wreck. Last July I had my uterus removed a sling on my bladder and I suppose to have rectocele repair. The GYN Doctor said:, after I removed the Uterus your colon snapped back in his old position so I did not need to do anything. My Urologist Doctor told me after I saw her for my 6 weeks check up the pressure you feel on your Bladder is your rectocele is back and it is stage 1/2.she told I was only the third one hundred. Last week I had my yearly checkup and was told by the PA your now a stage 3.let me consault with the Doctor.. she came back and said we will try a pessary I told her I am not a candidate for a pessary Her Answe:but if its put in correctly you wont feel it. I told her I had 2 Doctors try this and that is why I decidet to have surgery. well she tried.. lots of pushing and pain. It came out when I stud up. well we will try the doughnut shape I told her this is the last one. starting to push up I crinched and she said I will quit and your bleeding...Coming home I have not bin the same. I have so much pressure on my bladder and it feels like everything gotten much worse. She also mad an appointment for me to see the Doctor. I know what that means more surgery. I am so scared and cry often.
sorry for my spelling. I have ordered the DVD first aid for Prolapse what book should I read ? I am doing Kegels. the Pa said you have a very week Pelvic floor.. Anybody out there that had a little success Just let me know. Thank you and God Bless PS. when they took my Uterus out they found Cancer in my Uterus, so I cant take any hormone cream.

I am so sorry for everything that you are going through. Visits to the doctors office can be a very scary thing. I just wanted to let you know that kegels are very bad for prolapse. I havent had any surgeries so i dont know how much it changes to have the surgeries, but I do know that kegels made my prolapses get much much worse. When i stopped doing the kegels and started doing the Whole Woman posture it dramatically improved my prolapses. I hope that you can find the help you need and i am praying for you.

OMG I did not know. The whole woman does not do kegels? How can you strengthen your muscles and make them more tighter.I started doing Kegels every day since last week

Hi lindelu

The ww posture and exercises strengthen the muscles that you need to strengthen. Christine has created the 'new kegels' which fit in with ww posture & exercise.

You can find them in her 'blog' on this site. http://wholewoman.com/blog/

I hope this helps

:-)
w2k

Welcome lindelu. Traditional kegels do not help prolapse and can actually make it worse by pulling the organs in the wrong direction. I did them for decades and ended up with multiple prolapsed organs, so I see no reason ever to do them again! If you go to the Blog tab up above, and put the word "kegels" in the search box, you'll find several of Christine's articles on the subject.

Rectocele repairs have a very high failure rate, and probably higher amongst women who have had other surgeries as you have. Do make a serious effort with Whole Woman posture. It's your best hope of keeping the remaining organs where they belong, and it is extremely good for hips and spine. Post-hyst and post-repairs, you will have more of a challenge on your plate, but I don't think further surgery is the answer. Good luck to you! - Surviving

Thank you and how many Kegels does everybody do a day I have to do them sitting down,or later standing up after I learn more. My knees are shot ..

None!

I'm assuming you followed Surviving's directions and found the "New Kegel" video or description of how to do the "New Kegel" and that is why you asked about doing them sitting down or standing up. I have a pretty rough time doing them sitting back on my feet as shown in the video because of my knees. It seems better to me to do them on a chair as an exercise. Why don't you start with a low number of repetitions and see how it feels? If you do several (as little or as much as you feel comfortable with) for a few days and experiment with which of your chairs feels best and doesn't make your "sit bones" sore, then you might work at doing more or doing some more often. I often do a few standing (bending with my hands on my legs) during the day to get re-positioned and get some relief for my back and from the heaviness and pressure.

I hope that helps. It might be a matter of unfortunate confusion to hear "Don't do kegels" and "Do the New Kegels."

Agree with Bebe, it is confusing. I understand what Christine was trying to do, but I think the term "new kegels" can be quite confusing to new members here, who have not yet even begun to absorb the posture and breathing concepts taught here, and may be still hard at working kegeling. It's a bit "out of context" and it is pretty well impossible to assign an entirely new meaning to the word. I think ol' Dr. Kegel has had his day! - Surviving

I think in the first aid for prolapse she calls them pelvic rocks. I like that name.

I agree! And the breathing sequence is SOO critical. Original kegels had nothing to do with breathing and everything to do with squinching your muscles. - Surviving

It occurs to me that you might have a friend or daughter or husband to observe your posture and exercise (after looking at the WW info) and help you to know if you're doing it right. Otherwise, use a mirror. I began doing the exercises from the book with a mirror and think it really helped. Good luck.

I have observed an improvement in my lumbar curvature over the course of the last 3 years since starting this work. I can see it in the mirror, especially if I turn sideways and bend from the hips. For a long time I was "feeling" the lumbar curvature, but was disappointed with what I saw in the mirror. I am seeing a difference now! - Surviving

I feel your frustration. We are about the same age, I just had my 75th birthday, and have a hysterectomy. It is a battle to get through every day with my body failing me. Good Luck with your efforts.

Hi Lindelu, I am a Whole Woman Practitioner. I started answering a post of yours in a different thread, then, realising that you have had an hysterectomy and a bladder sling by reading your posts here I have abandoned that Comment, and am answering you here instead, for the benefit of others too. Here goes.

Saving the Whole Woman, Christine's book, has two very good chapters on surgery, detailing what happens in each procedure, the success rates, the side effects, and possible combinations. All this information is referenced from peer-reviewed medical journals, so it is all accurate. I would suggest that before you have any more operations, that you purchase this book and read these chapters. This is the only place you will find all the information about the common repair procedures all in one place.

I hear a lot of fear in your voice, both of what is happening in your own body, but also of the urologist. By learning more about your body and about prolapse you will become more familiar with your body's functions and begin to trust it again. The urologist does have the knowledge and ability to do the repair procedures, but she does not have the power to make you do anything. She cannot make you have a repair. She might try and frighten you into it, though, because these procedures are her only tools, and inducing fear is the only method of doing her 'good work' when the patient is reluctant (for her own reasons).

I suggest that you mentally take all *her* clothes off the moment you walk into the room, and you will realise that she doesn 't seem as threatening or powerful as she does in her white coat and professional clothes and makeup. ;-)

I also suggest that you take someone trusted with you into the consultation. Fear does horrible things to people when they want to ask questions, and understand the answers. Having a trusted witness will help you to debrief afterwards by helping you to recall what was said by taking notes during the consultation and referring to them afterwards.

It is also useful to take a written list of questions, and for your support person to have a copy too, so she can prompt you at the end if you have not asked any of the questions.

It is never too late for pelvic floor exercises, as long as you are doing them properly. *but* ....

'Rocking Kegels', Christine's New Kegels, will exercise a lot more than the pelvic floor. They are designed to move most of the muscles in the torso as well. Pelvic organ support relies not only on the pelvic floor muscles to stabilise behind, but also on all the muscles that create and reinforce the lumbar curvature of the spine, and maintain strong upper body musculature, around the upper back, shoulders and chest. These are just as important because their strength supports the body in Whole woman posture, which keeps the pelvic organs out the front of the body.

HOWEVER, (Yes, I am shouting out loud here to ensure that you hear this bit, if nothing else), firebreathing and the new Kegels/pelvic rocks are very strong in their effect. They really mobilise organs, fascia and muscles. You have had a bladder sling, which will be joined to you at both ends with sutures and now with scar tissue as well. You also have no uterus to connect the bladder to the rectum (via the cervix and the fascia joining bladder to cervix and cervix to rectum). It looks from your description that there is now nothing holding your bladder and rectum at the midline, or tethering one to the other. They are completely free to move, except for the sling suspending your bladder. The sling may also be fused to the vagina as well. I have no way of knowing exactly what was done.

Doing these strong exercises after any surgical prolapse repair or after hysterectomy may pull tissue and organs in a way that irritates nerves, tears sutures and strains or further damages soft tissue. Remember that they are very strong exercises. You could damage yourself by doing them.

I would prefer to see you breathing with your diaphragm, pulling up strongly into WW posture, and doing only the exercises that will strengthen your feet, ankles, legs, arms, shoulders and neck. You can also do other torso exercises, except pelvic rocks and pelvic circles, but do them only to the point of any discomfort. Do not go past a very mild tugging sensation, then pull back, because your pelvic region has some non-distensible material in it. Pulling more than very mildly may tear your own tissues. The sling itself will probably remain in one piece.

You could also do some extra gentle diaphragmatic breathing (which is the Whole Woman style of breathing in WW posture) , either in a chair, or in firebreathing posture, either hands and knees or standing, knees bent and bent over with hands on knees, or lying down, or however you are most comfortable. Just don't do the firebreathing part, just inhale through your nose and allow your belly to relax and expand, then exhaling and pulling your belly comfortably in toward your spine, stopping exhalation if you feel any pelvic pressure or pulling.

These WW workouts are *not* like many other workout videos. They are not designed on the 'no pain, no gain' principle. They are designed to strengthen and increase flexibility so that the woman can more easily maintain her WW posture. If you have doubts about how far you can push it with these exercises I strongly suggest that you seek out a Practitioner and get some personal guidance on exercise.

Best wishes

Louise

Wow. Thank you, Louise. Invaluable information for post-hyst and post-repair. - Surviving