Sigmoidocele

Submitted by louiseds on November 28, 2010 - 8:56pm
Body: 

OK, here is a definition of this condition from the American Society of Colon and Rectal Surgeons.

Sigmoidocele
A sigmoidocele is a protrusion of the peritoneum between the rectum and vagina that contains sigmoid colon. Sigmoidoceles are classified by the position of the lowest loop of sigmoid during evacuatory effort on defecography. A first-degree sigmoidocele is above the pubococcygeal line, a second-degree sigmoidocele is below the pubococcygeal line but is above the ischiococcygeal line, and a third-degree sigmoidocele is below the ischiococcygeal line.

I think it deserves a topic of its own, rather than derailing Colorburst's topic, so let's talk about it here.

I have never heard of it before, but it obviously exists. It appears to be quite an ununcommon accompaniment(?) of POP. I also picked up that it is very hard to diagnose with an internal examination, so maybe you don't have it at all?

"Welcome Sigmoidocele, to our Forums."

And welcome Shekina!

We learn new things every day. It sounds pretty straightforward to me. It is just another aspect of fascial structures becoming damaged and allowing the pelvic organs to slide back and down. Doctors give these conditions long and complicated names that are derived from the word labels they give to body parts. Nothing wrong with that. It makes medical description more exact. We would be lost without them.

Sigmoidocele only differs from other POPs in the name of the part that is causing the problem by being out of place. All these celes are really just *symptoms* of damaged endopelvic fascia, exacerbated by poor posture, poor diet, after-effects of surgical procedures, and pelvis-hostile lifestyle and environment. We can affect changes to all the latter factors, even if we cannot restore the fascia. When all the latter factors are attended to the damaged fasciae have a much easier job and can often keep the organs where they should be for optimum positioning and function.

I wouldn't expect any doctor to be the final word on whether or not you can get rid of its troublesome symptoms by exercise. I guess it depends on what you mean by exercise. The doctor probably is talking about Kegels, and their associated exercises. If so, I totally agree with her/him.

However, 'exercises' are only part of the story with any cele. I would think the most important factors for you, Shekina, would be bowel health, so your bowel contents are always soft enough to pass easily, and WW posture, which will keep your bladder and uterus flopped forwards and allow the sigmoid colon to come forward over the top of them, rather than being stuck behind your uterus, and trying to slide down between your rectum and your vagina, and protruding into your vagina, when you use your bowels.

Your aim will be to reposition your organs, probably on a continual basis, and having posture that will allow and encourage your organs to assume more normal positions is what you need. These are on the DVD. They are to give your whole pelvic area flexibility and movement on the inside, and to strengthen your whole body so that it supports you in this new posture. Exercises like firebreathing and nauli use the principle of abdominal vacuum, using the respiratory diaphragm to suck your pelvic and abdominal organs towards your chest, and allowing them to fall back into more normal positions, just like rearranging a beanbag, or washing and stretching to shape a woollen garment before lying it out to dry.

I wouldn't expect a medical specialist to either be interested in this, or to have the time or inclination to understand it. They don't treat women with an exercise modality. They treat women with surgery. That is simply how they are trained.

There are lots of women on this site for whom this 'using your own body to normalise itself' method has worked well.

BTW, I think Christine was thinking that sigmoidocele was the sigmoid colon, rather than the small intestine, coming down with the vaginal vault. This small intestine intrusion into the vagina is called enterocele, and it is really only seen in women who have had hysterectomy. That is why she asked about having your uterus. Thank goodness you do have it. It will be your ally in dealing with the sigmoidocele. :-)

I think we get very variable diagnoses from our doctors because the body changes from day to day and at different times of day, particularly re the distribution of our half-digested food in our intestines. That is why they move about so freely in our abdomen. They have to, so they can keep moving. An examination is a moment in time. Another examination by another doctor at a different time will probably give a slightly or completely different diagnosis. As I said before, I regard prolapse as a symptom, not a condition in itself. It is symptomatic of suboptimal arrangement of your guts. You can deal with that!

Stay with us. Let's see if you can affect some changes yourself without being carved up and surgically rearranged. Give it a go for 12 months. If it doesn't work you can go back to the doctor for a more invasive and risky solution, which may or may not give you a better result.

Louise

Christine

November 28, 2010 - 10:41pm

Thank you for such a thorough review, Louise. :)

I think both sigmoidocele and enterocele could probably be considered misnomers, since hernias are usually named for their locations, not their contents. A more accurate term would be “hernia of the cul-de-sac of Douglas”.

This is a very rare prolapse in a wombed woman, because the connective tissue that surrounds the cervix and becomes the uterosacral ligaments walls off this shallow envelop of peritoneum (lining of the intestinal cavity). In other words, the cervix and its connections to the sacrum lay against the cul-de-sac, preventing abdominal contents from slipping into it and sliding down behind the back vaginal wall.

When the uterus is removed, so is the major structure holding the intestines out of the peritoneal sac, making these “celes” extremely common. When the vagina is moved forward with incontinence surgery, this area is left exposed as well.

An enterocele (the more accepted term) is easily felt by placing your thumb in your vagina and first finger into your rectum. You will be able to feel a finger-like bulge at the top of your back vaginal wall.

Some very small percentage of women have a congenital defect resulting in an abnormally deep peritoneal sac. This can manifest in a prolapse independent of cystocele/rectocele, so it’s possible this is what Shekina has been diagnosed with.

I agree with Louise that none of this is about the pelvic floor and improvements can only be made by tilting all the organs forward so they are better supported by the lower abdominal wall.

You would certainly want to pay very close attention to your diet and make sure never to strain against the toilet seat.

Welcome to Whole Woman!

Christine

Shekina

November 30, 2010 - 8:34am

Thank you very much Christine and Louise for your extensive explanation, it is really comforting to hear these kind of information when you feel you are standing alone with this condition.

Since last year that I started having bowel problems, unexaplained pains in my colon, also started to feel this pain in my rectum and the feeling of a bulge in it. All pains have gone by now, also the pain in my rectum.
But always when I have to defecate, I feel a big bulge in my rectum/vagina.

One thing I really need to be sure of is how can I sit correctly on a chair at work or anywhere else, since I always have these bulge feeling in my rectum, I don't want to make it worser by sitting on it. My thoughts are that I will push the organs more downward and out.(It's a fear).
What I have been doing to sit is: sitting on one side of my buns(gluteus), since 1 year already, and I know it is not good to that.

Please advise, thank you so very much.

granolamom

November 30, 2010 - 8:04pm

welcome to wholewoman, shekina
have you had a chance to read up on the wholewoman posture? it can be done in sitting as well as standing. the point of it is to tip your pelvic organs forward, so that they are resting in the low belly over bone instead of being pushed out of the vagina.
when I sit, I sit at the edge of my seat and never with my back leaning on the back of the chair. then I pull into ww posture, that is making sure my neck is good and long with my chin pointing down (not jutting forward). shoulders wide and down, separate your breasts and belly as much as possible, and there ya go.
personally, I have a hard time keeping my feet flat on teh floor unless I also tip the chair up off its back legs (which my mom and teachers constantly scolded me for!) or tucking my feet under the chair's lower crossbar if it has one (not sure what that's what its really called).
I hope this makes some sense, play with it and see what feels right.
but sitting on one glut for a long term solution is probably not a good idea (as you know!), it will set you up for some back pain.

Shekina

December 1, 2010 - 6:14pm

So, then most of your weight will be resting forward, your tailbone actually will have no pressure at all?
What I do have at work is a little stool, to rest my feet on , so that my short legs don't keep hanging, I am petit (1.50m)

Now another thing is, what kind of footwear is ideal to use with POP?
I know absolutely no heels! But do you recommend some special kind of footwear for the proper alignment of your back, in connection with POP?

Will do my best at it

granolamom

December 1, 2010 - 9:06pm

when I sit, my tailbone has no weight on it. its actually not even making complete contact with the chair at all.
I am not tall (5ft5 in) and most of my height is in my torso, so my legs are on the short side. would you need the stool even when sitting at the edge of the seat? try different things, whatever works works. only I wonder about the stool giving your legs too much height. make sure your knees are not higher than your hips, that would tend to push you back onto your tailbone.

as far as footwear, I go barefoot most of the time, but I'm a stay-at-home-mom so I have that luxury. aside from that, I mostly wear ballet flats. nothing special, just comfortable. I do wear heels when the occasion calls for them, and I'm ok. harder to maintain posture that way, but I don't wear heels more than a few hours at a time and rarely more often than once/week.

louiseds

December 2, 2010 - 5:37am

Try the search box for 'shoes' Shekina. We discuss them repeatedly.

I figure that I came out of my mother's womb without shoes, so why do I think that shoes can do anything for me except stop me stepping on broken glass and prickles, and maybe keeping my feel warm, safe and dry when needed?

I spend most of the warm months barefoot or in flipflops/thongs/jandles. I have gardening thongs, going into town thongs, and patent leather thongs for going out, or if I have to look respectable and stand up all night. I also have a couple of pairs of sensible solid sandals that I can wear orthotics in, but I hate them because they squash my toes and generate a lot of friction and heat, even though they fit me well. They come off as soon as I step in the front door.

For winter I have Ug boots for everything except mud and going into town. I also have strong work boots for using the lawnmower and other machinery, and in the workshop and sheepyards. I also have good quality laceups for going into town or for work, a pair of slip-on loafers and a pair of flat-soled dress boots.

Oh yeah, I also have a couple of pairs of high heels that are somewhat symbolic, as I only wear them about twice a year.

The end of the story is that I will get out of wearing shoes whenever I can. Expensive, good quality shoes are often good enough, but sometimes have unexpected disadvantages. Cheap shoes are usually not good, except for rubber thongs, which I could not live without!

Louise

louiseds

May 27, 2011 - 7:44am

Hi Shekina

Remember this topic? Read right through it again and see if you pick up anything about sitting.

I also think you might benefit from firebreathing and nauli, kneeling on knees and elbows and doing some cat and cow stretches a few times a day, or even my jiggling exercise, to encourage your colon to come out of your pelvic cavity, so there is no extra loop hanging down. This will be especially important after a bowel motion, when your intestines are making themselves comfortable again after their contents have shifted around inside you.

It can very difficult to get your bladder, uterus and rectum into their correct positions relative to each other unless you can literally tip them out of the pelvic cavity by inverting it, or at least taking the downward pressure off them, and sucking them deeper into your abdomen with these exercises. Wholewoman posture principles then kick in.

Raise your chest and relaxing your belly tilts your pelvis forward slightly. Your bladder and uterus tumble forwards on your pubic bones, and the top of your vagina moves backwards and up, as the uterus rotates forwards and the cervix rises up higher. The top of your sacrum moves forwards towards your belly button. This pins your organs forward and prevents the loop of intestine from slipping back and down behind your vagina. The top of the vagina has moved backwards and effectively closed off the Pouch of Douglas, so there is no sink hole between rectum and vagina for the loop of intestine to fall into.

This will not work for very long at first, but hopefully you will become more adept at correcting the positions of your organs with practice, and getting that loop to get up out of your pelvis and back into your abdominal cavity where it belongs. Naughty loop.

Remember that you can also use the Search box to find more posts about sitting, and about rectocele. This is really a very low rectocele.

Louise

Shekina

May 27, 2011 - 11:45am

Thanks Louise so much for your information, I went thru all again and it feels good.
Something that I also feel is pain at the tissue of muscle I dont know what the names is, it is between your vagina and rectum, that hurts a lot in me, well after the D&C procedure it was hurting really so much, the pain has gone by now, but still feel it somedays. And what I dont understand is that whenever I have my period, the first 2 days, all the pain that I feel is in my rectum, not even my uterus hurts, but it is all in my rectum, why is that ???
Louise where can I find how to do the cat and cow exercises dvd??
What I have is the Saving the wholewoman dvd, and the dvd of the elderly people.

Oh thank you Louise for helping me out, I am very gratefull !!!

Shekina

May 27, 2011 - 11:58am

Oh Louise I forgot to tell you something, like 6 years ago, I had done a procedure called Laparascopy, for the docotrs to check for a weird pain I had on my left side, near my left ovary, and those doctors have removed the 2 ligaments of the uterus the ones that are below, I think you have 2 big ligaments above, and 2 small below, thats what they explained to me, they have cut them out because they were very inflamed, red or sick I dont know, so I think my uterus is hanging form the 2 above ligaments only ????? Could that be a reason for sigmoidocele, after years ?

louiseds

May 27, 2011 - 7:25pm

Hi Shekina

It may very well be that the problems that you re experiencing are related to the results of that surgery. All the ligaments of the uterus have a function. Your uterus is now trying to stay in place with limited support. I was thinking, with your descriptiion of rectal pain that your uterus may be retroverted as mine used to be. I used to get rectal pain with menstruation. Now I no longer even menstruate, so I can't check! ;-)

The round ligaments hold the uterus forward. I am wondering if these are the ligaments that were cut? This may have allowed your uterus to flop backwards and I think put pressure on your rectum.

It would be helpful if you could get access to the medical/surgical record and find out the names of the ligaments that were cut, and what else was done at the time.

Cat and cow is shorthand for getting on hands and knees, or elbows and knees, arching your back, holding for a few seconds, then letting it go hollow. Do it a few times.

Louise

Shekina

May 31, 2011 - 11:47am

Hi Louise!

I checked for records on the procedure I did so many years ago, for the removal of ligaments but couldn't find nothing, since I have done that in Colombia.
I went thru the internet and saw the imgages of the ligaments of the uterus and I remember pretty sure that they were ligaments that were like in the area that says uterusacral ligaments.

after this miscarriage and curatage procedure, I really feel something in my bulging in my vagina, I think its when I have a bowel to be emptied and it is painfull in that perineum area inside up.
like the backwall of the vagina????????

Louise, in all cases, bottomline, is with all that I have explained to you with removal of ligaments and so on, I can still do all the instructions you told me to, Cat and Cow, Nauli Firebreathing, ww posture...and jiggling exercises(but what is that).??

thanks so much for all the information and I really need all advices and infos possible to conquer this situation, the Victory will be mine!!! Yes I can do this!!!!!

louiseds

May 31, 2011 - 11:32pm

Hi Shekina, have a look at this topic,
http://www.wholewoman.com/drupal-6.16/node/2865 . The description of jiggling is in one of my posts, called Pain, addressed to Skydiver, about 3/4 of the way down the page.

You can use the search box to find occurrences of keywords throughout the Forums.

Louise

csf

June 1, 2011 - 3:46pm

I really believe in the jiggling. WOW a sentence I could never have imagined writing one day! lol

I think of it as those games where you have to shake a toy that has tiny balls that you need to somehow roll around until they land in the little indentations that can keep the balls in place, but just barely. One wrong jiggle while trying to jiggle this or that ball into place will knock some other ball out of place. hahaha I imagine that our organs have a place, that is sort of like those gentle, subtle indentations into which we can get the organs by simple jiggling. But that it has to be just so to get them carefully placed. I noticed with those games though that if you jiggle long enough eventually things DO just simply fall into place even without some perfect strategy. lol

When I went swimming (after driving over a bumpy road) and I was leaning left, right, center, left, right center in the water, I really felt like that was the ultimate click for my organs getting into their slots. I walked out of that pool a new woman.

I really think they can find their place if we don't obstruct them, let them have freedom to move where they need, don't overfill them, and avoid swelling type things. I even noticed sleeping on my stomach is doing wonders! Today I went to sleep in the sun for a little bit and was so tired from being up all night at work that I almost fell onto a straight lawn chair that has weaving (and that gave way to my face down belly) - and I feared how that would affect me - the lack of thought.

Well, when I woke up, I could have lept off the chair I felt so good! lol I can even go upstairs, uphill, lift my legs - and all stays in place. I noticed I need the shark c - and I noticed that even the HINT of anything EVEN REMOTELY tight in the very, very least - makes me have a sensation things might go in the direction I don't want them to. So I am living in dresses. : )

Trick now is unwinding after these long night shifts and after getting errands done on the way home. : )

Been soooooo busy. : ) See? I have a life again!!!

louiseds

June 2, 2011 - 1:21am

I find jiggling to be more like shaking a jar full of onions, getting them to pack down tight before I pour the pickle in, so they are filling up all the spaces and bottom edges of the jar. It is like putting the jar on a lean (like the pelvis), jiggling and letting them pack down tight into their right spots, rather than a flat plate with small indentations. You really cannot overdo the jiggling. Once you have the bladder, uterus and intestines as far away from the vagina as possible it is simply a matter of moving your waist upwards to vertical again, and they will stay away from the vagina more easily.

I agree about the driving on bumpy roads. I feel especially strong if I control my torso with the muscles around my hip joints while going around corners without my back against the back of the seat.

Ooh yeah! I got on a drum kit last night for the first time ever. Using both feet on drum pedals , in rhythm, was another very 'strong-making' activity. The sound was good too, but everyone can hear when you stuff up!)

L

Surviving60

December 29, 2011 - 9:45am

Thanks Terpsi. for putting a comment here. I just read this entire thread for the first time, and it is jam-packed with information we all need to review!

gfkspicoli

February 1, 2012 - 4:32pm

I too find it difficult to "let things be the way they were then!" For our whole lives we've been told to stand up straight, by our mothers and then by the entire physical fitness and exercise industry. I'm working on relaxing my back and have my new copy of Saving the Whole Woman to study ways to relax into the natural curve of our spines.

louiseds

February 1, 2012 - 7:56pm

Yes, Terpsichore, I can vividly remember standing waiting for my gymnastics class to begin as a seven year old, and hearing someone commenting on the large curve in my spine, and a conversation between adults that followed, saying that the gymnastics would probably straighten that curve. Hmm, it probably did straighten my back. I would love to slap them all now! Why couldn't they leave well alone?

Childbirth educator

December 24, 2018 - 8:54am

Hi ladies, would like your advice please. A 40 years old woman from my community was diagnosed with a 10 cm peritoneal cyst. As far as I understand these cysts are similar to the hernias that Christine describes at the beginning of this thread. I found a good description of it at the ncbi site in an article named “pelvic pain and history of previous pelvic surgery”. (I’m not if I can put a link here).

She has pelvic pain in her left side but she can feel the cyst moving. She also occasionally suffers from constipation that only resolves with a two days bed rest, she can’t see any connection to her diet.

I wonder if Christine and louiseds’ advice here could give her some relief- good posture and toileting habits. And would anti inflammatory diet and fermented food help healing.

Thank you so much!

Childbirth educator

December 24, 2018 - 9:12am

I didn’t mention that she has had 6 cesarean surgerys and in the last one her uterus was removed. She also had a drainage of the cyst awhile ago but it reoccurred.

Childbirth educator

December 24, 2018 - 9:50am

I didn’t mention that she has had 6 cesarean surgerys and in the last one her uterus was removed. She also had a drainage of the cyst awhile ago but it reoccurred.

Surviving60

December 25, 2018 - 9:49am

No one here except Christine herself (or maybe another WW trained practitioner with a medical background comparable to hers) can really render a medical opinion about your post. I'm unclear on your comparison because to me, a cyst is a closed sac filled with something, not a prolapse or a hernia.

That being said, the measures you suggested, as well as everything else in this thread, are basically what EVERY woman should be doing, for her pelvic health and overall well-being. So, the answer to that question is easy.

THAT being said.....given that she has had hysterectomy, there are more challenges there, as well as some caveats. Different dynamics when the "hub of the wheel" is not there to support the other organs. Following WW principles to the greatest extent possible is the best advice we can give her. Christine has a whole streaming video program dedicated to post-hyst issues and self-care. - Surviving

Childbirth educator

December 27, 2018 - 11:04am

I appreciate it a lot!

Childbirth educator

February 20, 2019 - 3:12am

I'm so happy to update that this woman's huge peritoneal cyst is gone, no one knows how!
she is interested in learning about the WW approach, but is looking for written materiel mainly. Any ideas were can she find written info specific for post hysterectomy women? Thank you so much!

Surviving60

February 20, 2019 - 3:42am

This probably exists as part of the course materials for WW practitioners. Based on this and your other posts, I think you should consider applying, next time it comes around. - Surviving