Question about splinting

Submitted by queenmother on September 23, 2009 - 12:28pm
Body: 

I can't help but put a *TMI* warning here, even though I know everyone here can handle it :)

I came to this forum a while ago - maybe last year? - and haven't spent as much time on the computer since, so you probably don't remember me. A re-introduction: I've had two kids, the first vaginal birth was very fast with an episiotomy that extended to a 3rd degree tear. After baby #2, I was diagnosed with a cystocele. About a year later, a new doctor confirmed the rectocele I knew I had, due to very slight bowel incontinence/soiling issues.

I got a lot better with attention to diet and physical therapy that worked on not just kegels, but also building strength in lower abdominals, hips, thighs, butt, everthing... my PTs were very in line with Christine's philosophies, though obviously they put more stock in the kegels than she does. So it worked out.

Fast forward to recently: I let myself get constipated, and boy do I regret it. For the first time I just couldn't pass a stool at all. My PT had suggested before that I might get a more "completely empty" feeling with splinting, and I tried it, and I could feel the bulge in my vagina but pushing on it didn't seem to help at all.

After a dreadful evening that I am certain set me back a full year (if not more) on both 'celes, I finally learned for myself how to splint. It turns out I need to press directly on my perineum. Now I am having to do this every time. It helps a LOT, though I'm not thrilled with the need for a new routine.

My question: Is that still a rectocele? I can still feel a big bulge (esp. with hard stool) higher in the vagina, but pressing on it didn't help because I was just pushing things down into my perineum. So is this another kind of 'cele? I read a post about perineocele and didn't see much info on it. Does anything change about management strategies? Is this a common form of splinting?

Thanks for letting me share and ask. There's no one in real life I can talk to about it! My DH definitely does not want to know.

Sarah

mom30

September 23, 2009 - 7:43pm

For me, I usually after a bm, just reach my right thumb(freshly washed) up the vagina and feel if there is any "lumps" up there. If so, I just guide them right down and they come out. I really don't love it, but it really makes that "kinda have to go but can't feeling" go away (but not always).

louiseds

September 24, 2009 - 8:23pm

Hi Queenmother

My experience is slightly different from Mom30. If I get constipated with hard, dry stool, I find that Mom30's method gradually works, with physically moving the stool down, but if it is the sort of constipation where the rectum fills and half-empties but I feel that there is still a lot in there, I find that your method is usually more productive. I find that pressing down on the perineum does something like straightening out the last bend in the pipe. I keep my thumb there for a few seconds then remove it. Then I change position and often I can feel it come down by itself. The more I do it the more I understand about how my bowel behaves.

Your method usually works better if my bowel just stops sending it down. The peristalsis just seems to get very weak sometimes. Straightening the pipe is often enough to get enough movement. It is often stress-related.

If you have a look at a diagram of the digestive system you will see that there is a sharp bend just before the rectum. I think this is meant as a 'brake' to stop so much pressure coming down on the rectum when it is full. This kink may be sometimes be the bit that protrudes into the vagina, maybe even bending over further and down into the space behind the vagina. Splinting just striaghtens it out sufficiently for normal bowel function to take over.

When the fascia surrounding the vagina and the bowel and rectum become damaged I guess the bowel can slip around all over the place. It's not the same every time for me. My bowel has a personality of its own! ;-)

Cheers

Louise