Young man with rectoceles...where to begin

Submitted by RutherfordTheBrave on December 27, 2018 - 9:43am
Body: 

Hello all,

Following a defecography last week, I've been diagnosed with small anterior and posterior rectoceles and pelvic floor laxity. I'm a 24 year old man and I'm lost and confused and feel hopeless...all the medical literature on rectoceles seems centered around the female anatomy and I don't know where to begin in a journey towards recovery. I didn't even know that a man could have a rectocele. I feel extremely isolated and broken and alone. The scant information that I can find regarding men with rectoceles has to do with men in their 70s, and I'm terrified of having to live the remaining 60-70% of my life with this condition...mainly because I can't imagine that it will improve with aging, but that it will only get worse. I'm in desperate need of guidance.

Mainly I'm looking for the means to support my pelvic floor and prevent my condition from deteriorating further...a way to stop the progression of the rectocele in its tracks or even improve it if possible. Based on the nightmare-ish experiences that so many women have had with "repair" surgeries, I wish to avoid that route at all costs (though the idea of a permanent fix sounds enticing). I know that Christine offers many different materials but I don't know which would best address my condition, or even whether the info they provide would be effective for the male anatomy. I'd be deeply appreciative of any insight into this.

Since in women, a rectocele causes a bulge into the vagina, does it make sense that in a man, a rectocele would cause pressure against the prostate, seminal vesicle, and/or vas deferens? I have been dealing with weird affects on my sexual and urinary function so I imagine something like this could be going on. Before my most recent diagnosis, a manometry revealed that I have chronically tight non-relaxing pelvic muscles as well...but this sounds like the opposite of pelvic floor laxity, so I'm confused by the idea that I have both.

Presently, I'm dealing with difficulty passing bowel movements, what feels like obstructed defecation, and flattened stools. I feel that I often need to push through the entire bowel movement to get anywhere near a complete evacuation...I try not to strain but I don't know if this would qualify as straining or not. It certainly takes effort to have a bowel movement. I'm afraid this will get more and more difficult over time. Other symptoms I'm dealing with include:

- difficulty passing gas. Feels like my muscles are the pushing the wrong way to expel gas). Gas comes out in tiny silent puffs rather than in a satisfactory amount
- difficulty urinating...I need to very intentionally reverse kegel after the stream stops on its own to empty my bladder. Dribbling occurs afterward.
- tenderness/pain in my tailbone region when sitting - especially when sitting in my desk at work and when driving. Pain is greater when getting up from a seat or shifting in a seat.
- feeling of tightness during sexual stimulation, and an uncomfortable feeling at climax
- about a year ago I began having fecal smearing after bowel movements. This diminished and went away around August...it seems that it would have been a result of stool being trapped in the rectocele pouch after bowel movements. I think it may have stopped because I developed chronically tight pelvic muscles, which might prevent leakage...but if I improve this chronic tightness, I'm afraid my leakage will start again.

I've posted in this forum before - https://www.wholewoman.com/forum/node/7866#comment-58561 - at the time not knowing what the cause of my symptoms was. I was given some advice about how to have bowel movements properly (lifting off the seat), but even then it is difficult to go without significant pushing (which I suppose qualifies as straining). To begin with, I believe that my rectocele was caused by a long period of hovering over the seat while pooping (I misunderstood what it meant to squat when pooping). I'm trying my best to forgive myself for this terrible mistake...but now it seems wise to avoid anything that would resemble standing for bowel movements. The squatty potty helps me go but I've seen it said in this forum that the squatty potty only makes things worse.

I'm so confused and disheartened...I'll be grateful for any guidance you can offer.

Forum:

Christine

December 27, 2018 - 12:55pm

Hi Rutherford,

We are part of the nationwide Centurylink outage, so I will have to do the best I can to respond to your post on my cellphone.

Your story is very poignant and I’m sure reminds a lot of women of their encounters with the medical system in the diagnosis and treatment of prolapse. First of all, take a deep breath and try to relax, as you’re going to be just fine. The body is a miraculous self-healing organism, if only the mind will help it along.

Okay, now reach around to the back of your body and locate your anal sphincter - it is clearly at the back, correct? Now look at a few defecography videos and notice how the position of the anal outlet is portrayed. In order for the sphincter to be in that position, you would’ve had to have sat on the defecography chair with knees to chin and pelvis rotated >45 degrees backward. Software rotates the image into a fictitious orientation agreed upon by some governing medical society...

to be continued (so I don’t lose the post)...

Christine

December 27, 2018 - 1:07pm

...one very useful piece of information you may gleen from some of those images however, is how seriously the male bladder is pushed toward the back during defecation. In such cases ribbon-like stool must be squeezed out between bladder, prostate, and front rectal wall. Your doctors confirmed rectal wall pouching, but did they ignore cystocele? You may want to request to view the test yourself.

The bottom line, however, is that these tests and procedures are unlikely to help because they’re coming from a place of anatomical misconception and even deception, as mentioned....

Christine

December 27, 2018 - 1:25pm

...you are a horizontal creature from the hips down, and vertical from the waist up. Have you ever see a horse lift its tail and poop out the back? Your back passage is no different. Now understand how a sqatty potty rotates your pelvis backward into a position that is unnatural. In your previous posts from August you describe success with leaning forward to empty. My instruction in all my videos is: “you don’t have to hover - your skin can even stay in contact with the seat, but get your weight off.”

You also described improvement when you relaxed your lower belly. Search images for “signing of the Declaration of Independence” to see Whole Man posture. Every one of those men has a forward placed abdominal wall, strong shoulder girdle, and chin that is pulled in and down.

We have no way of knowing, but your symptoms sound like the classic effects of a chronically contracted abdomen and poor toilet habits.

WW breathing is foundational to the WW (WM) work. I will create a new blog post on this subject today.

Wishing you well,

Christine

RutherfordTheBrave

December 27, 2018 - 10:36pm

Dear Christine,

Thank you for your kind and informative response! I apologize for the delay in getting back to you; I was visiting with family since noon today.

OK, so I took a deep breath as my first step :) trying to be positive. I think I might see what you're saying about the fictitious orientation of defecography images, and I'll get in touch with my doctor's office to see if they're willing to send me the actual images from my test.

What you're saying about stool having to be squeezed between the bladder, prostate, and front rectal wall also makes complete sense - thank you for pointing this out! I don't know if they're ignoring cystocele, but I think they might have mis-named it in my test results as "anterior rectocele". They said I had both anterior and posterior rectocele, but I think what they might have meant was that I had cystocele and posterior rectocele (anterior prolapse being another term for cystocele if I understand correctly). Is there even such a thing as an anterior rectocele? I'll have to clarify this with my doctor, though so far they haven't responded to any of my questions in their medical portal :/

I think you are correct about poor posture and poor toileting habits contributing to my condition. I've had something of a sway back for some time, with my pelvis placed more forwards than it should be and my upper torso leaning backward somewhat from the pelvis. Is this what you mean by a contracted abdomen? I see that in the Declaration signing image you mentioned, the founding fathers are all standing with pelvis back(so that the butt is stuck out behind them more than mine is), bellies out, chin in close to neck (as if shielding the Adam's apple), and shoulders back (sorry if it sounds like I'm just rephrasing what you said; I just want to make sure I'm understanding your terminology correctly). Does this sound correct to you, or am I missing anything about the Whole Man posture?

Today I tried throughout the day to hold this posture. It feels very different from my normal posture. It's not too hard to maintain the posture while standing, but it's a lot more difficult for me to maintain when walking...tomorrow I'll put it to the test on a long walk in the woods. That will be good practice.

I will go back to the leaning forwards approach for bowel movements and see if I can get the hang of it again. I think I fell off this practice because I began believing that my symptoms were a result of a non-relaxing pelvic floor only and not a result of prolapse...but now that my test results are in, I know better.

I will look for the blog post on WW breathing! Thank you again! Which of your materials would you suggest I start with after this?

Also, do you think it's safe for me to be doing things like lifting 35-40lbs, or standing with a 10 lb guitar on my shoulder for 2 hrs at a time (in Whole Man posture)? I have no trouble doing this, and feel no effect on my pelvic floor, but now that I've been diagnosed with these prolapses I'm concerned that I could be doing damage without even feeling it...I am a musician so I am often carrying amps and gear between gigs. I am even beginning to wonder whether running is OK, or hiking with a backpack. There are so many activities that I've always taken for granted...none of them of give me any physical trouble right now. I wonder if it would be safe to continue them as long as I adjust my posture to that of Whole Man.

Might anyone have any insight on how to drive/sit in a car in Whole Man/Woman posture?

I apologize for all the questions. I hope I'm not overloading my posts. All this is just so new and scary to me. Thank you again for your kindness and help.

Best regards,
Rutherford

Christine

December 28, 2018 - 11:08am

You are very welcome, Rutherford,

Rectocele is a bulging forward of the anterior rectal wall. “Posterior rectocele” makes no sense to me, given the rectum is met at the back with the sacrum, coccyx, and powerful tendons to keep it in place. My guess is that the back of your bladder (front is tightly adhered to abdominal wall) and front rectal wall are bulging toward each other when you bear down to have a bowel movement.

Hoping you can see that leaning forward tips your bladder into place and also tips the heavy sigmoid colon to pull your rectum into alignment.

Yes, by all means we want you lifting and running! However, you need to pull into WM posture every time you’re on your feet. Carry your guitar high on your thoracic spine, which in men is built for heavy lifting, all the while keeping your “heart” (below collar bones) lifted toward the sky and chin pulled in.

If you don’t run forefoot-first, perhaps you would give that a try. You might even want to experiment further by walking ball-of-foot first. It gives a particular lift that counteracts all the years of leaning your torso back. Yes, I imagine your gut has been chronically contracted.

I would say you’d probably benefit most from our Save Your Hips program. Most especially it will give you a good look at how dysfunctional medical imaging really is.

Keep eyes peeled for new blog…it’s being formatted as we speak.

:-) Christine

RutherfordTheBrave

December 28, 2018 - 1:16pm

What a relief to hear that I should still be lifting and running! I'm so grateful to hear this, and grateful for all your input. I will be mindful of maintaining WM posture in all my physical activities.

This morning I went for a long walk doing my best to maintain my WM posture. It's feeling kind of stiff and unnatural at first, but I'm sure this is just because I've been in the wrong posture for so long, and my body is not used to holding itself like a Whole Man would. I'm feeling a bit of stiffness and soreness in my lower back from trying to keep my butt back and my pelvis beneath my torso - but I imagine this is only natural and my body will adapt. My left leg also feels pretty tight - all the way from the top of my foot through my shin along the IT band into my hamstring - but this was already the case (to a milder degree) even before adopting WM, and I think WM is just revealing how tight my leg truly is. Hopefully it will stretch and heal with WM maintenance!

Overall I think I'm beginning to get the hang of this posture! It's amazing how the position of something like the chin, way up towards to the top of the body, can impact the position of the pelvis. But this is making sense.

I'll keep my eyes peeled for the new blog! I just read your blog on "Stabilizing and Reversing Pelvic Organ Prolapse, Urinary Incontinence, Chronic Hip Pain with Correct Toes®" in an attempt to better understand what you mean about walking and running forefoot-first, on the balls of the feet. I get how losing one's arches causes lumbar curvature to flatten and the pelvic organs to shift backward, but I'm not sure I get how to walk correctly on the balls of one's feet.

In the past, I've always walked so that my heels hit the ground first, but I've always had more weight on the balls of my feet when standing in one place. Getting into WM posture tends to shift my weight back onto my heels when standing in one place. I tried walking balls-of-feet-first for about 20 minutes, experimenting to see about what kind of effect it had. It makes me feel almost like I'm walking in high heels...but I was under the impression that walking in heels created short tight pelvic muscles, and that we're supposed to shift our weight more onto our heels (which is what WM posture does for me), so I'm a bit confused here.

Do you think that flat shoes with minimal heels would be best? In any case I'll look into Correct Toes!

But on another positive note, I tried the leaning-forwards-approach for my bowel movement this morning, and had success with complete emptying! The stool was still flattened but I'm sure it will take time for my organs to re-align properly so they're no longer obstructing and flattening my stools.

Your knowledge and wisdom and its positive impact on this online community is giving me hope. :)

With gratitude,
Rutherford

Christine

December 28, 2018 - 2:37pm

Importantly, we don’t try to stick the bum out the back because that creates a lot of stress in the sacroiliac joints - probably the discomfort you are feeling. Sticking the bum out, putting most of your weight on your heels, or pulling your thighs back (an old yoga instruction) will all get you to that same unanatomic place. We do not agree with others who teach to “walk the pelvis back” and place most of the weight on the heels, which aligns you to an antiquated model of a straight plumb line from ear to ankle. The ear and ankle should be aligned, but the Golden Spiral in between is key.

Completely relax the pelvis, lift the chest, and tuck the chin. Walk with toes pointing straight ahead and you’ve got it! Yes, the posture will reveal to you structural misalignments, which usually involve an entire side of the body.

Changing your gait is a bigger deal than it seems, so just play with it and see what you discover over time. “Barefoot” running is a great place to start. Forefoot-first is not at all like walking in high heels because the arch has great mobility, and is working like a coil to dampen every step. This type of walking allows the calves their full ability to pump, which acts as a “second heart” to optimize venous return.

So glad you're seeing results!

Christine

RutherfordTheBrave

December 28, 2018 - 6:11pm

Alright, I'll be persistent with walking forefoot-first! And I'll make sure to align my toes straight ahead as well. Do you use minimal shoes like Vibram Five-Fingers or anything like that for "barefoot" running?

It's a good thing you told me not to stick my bum out, or I'd have been doing WM all wrong! When I relax my pelvis completely, it does tend to shift forward in a sway-back kind of posture...but I'll try to strike a balance, not letting my pelvis thrust completely forward, but not sticking my bum out either. It seems like the key to this balance will be maintaining the other elements of the posture you described...a belly-out, forward-placed abdominal wall, tucked chin, and lifted chest. Hopefully focusing on these elements of the posture will prevent my pelvis from thrusting forwards.

Is it common for rectocele to be accompanied by a tight, non-relaxing pelvic floor?

I'll update this thread with my findings as I progress with the approach you've outlined! Thanks again! :)

Christine

December 28, 2018 - 7:55pm

Your pelvis is already tipped all the way forward, and your pubic bones underneath you like straps of a saddle. Undoubtedly, your “swayback” is a low, sharp curvature at the base of your spine. The correction is not to try to change the position of the pelvis, but to simply relax the pelvis and lift the chest. The low curve then becomes a natural wide-radius curve comprising all of the lumbar spine. You can’t hyperextend the upper spine because you are keeping your shoulders down and chin pulled in.

Yes, five-finger shoes or other wide toebox shoes or moccasins are necessary so you can spread your toes out. Most of my shoes are unsuitable for forefoot-first walking. It really is a much bigger change than one would expect, and should be considered carefully and worked with slowly.

RutherfordTheBrave

December 29, 2018 - 9:24am

OK, I think I get it! When I lift my chest and pull my chin in while keeping my shoulders down, it seems to correct my pelvis synergistically, without my having to deliberately shift my pelvis backwards. Awesome! Looking in the mirror I can see the distinction between the low, sharp curvature of my previous posture and the wide-radius curve of WM.

Right now I'm focusing pretty intently on the upper-body aspects of the posture, to make sure I really integrate them and get used to them. I'm sprinkling the forefoot-first walking in little by little, and hope to increase it as the other elements of the posture become more natural to me.

I'm also going to start doing pull-ups to increase my upper-body strength so that I can lift more safely, so that I can rely more on my upper torso and put less strain on my pelvic muscles when lifting. I figure this will also help me lift my chest skyward more naturally. I'm a pretty skinny guy - about 120 lbs at 5'6" - so supporting my pelvis with a more substantial musculature on the rest of my body will probably help me in the long run.

It means so much that you've taken your time to offer me this guidance :)

Surviving60

December 30, 2018 - 4:57am

I am not a runner, and in the dead of winter I don't walk outside either. And incorporating forefoot walking into my life is still a work in progress, to say the least. But I know it works, because I am finding great benefits from just 5 or 10 minutes daily of simply running in place on the forefoot, combined with running back and forth from room to room. And throw in a little bit of gentle jumping. I don't like jumping jacks because they tend to make my toes turn in (when landing with feet spread apart). But jumping in excellent WW/WM posture, landing on the forefoot with plenty of room for toes to be spread, is another one of Christine's proven tips.

All of this constitutes an easy way to experience everything that she talks about in this thread. - Surviving