Rectocele causing leaking

I would think you are spot on with your own diagnosis. We sleep lying down, so gravity is working in the wrong direction for keeping our bladder and uterus forward on the lower abdominal wall. You might have to work around this. It would seem that there is nothing life threatening going on, though the cyst may be uncomfortable. I know nothing about ovarian cysts.

I do know that a full large intestine sometimes seems to interfere with bladder emptying. Sometimes I will have a wee, then a poo, then I am ready for another wee again. Sigh.

To get more complete emptying of your bladder, try keeping your knees well apart, so your belly can sit down between your thighs and almost rest on the seat. This will roll your bladder forward and iron out the kink in your urethra. When your bladder is in normal position it comes out the bottom of the bladder. When your bladder prolapses it rolls backwards and its top ends up against the front vaginal wall. The base of it ends up at the front, with the urethra kind of coming out halfway up the wall. It is very difficult to empty a bath tub that has the plughole halfway up the wall. It needs to be at the lowest point. Allowing your bladder to roll forwards gets the urethral opening at the bottom again, so gravity will help. Also, it is easier to stumble along in a hunched posture to even get to the toilet when we are half awake, so the whole body needs to be stretched tall, once you are sitting down, so you can roll your bladder forwards properly and not fall forwards off the pan. Talk about things that go bump in the night. Ouch!

After your first 'finish', stand up, or half stand up, then sit down and repeat the process. You will probably find that you will wee a bit more. Do it again if necessary until no more wee comes out. Wear panty liners if you feel better doing so. No need to feel guilty about it. You didn't cause it by doing something wrong.

Another thing to try is to do Kegels regularly, just twenty or so, spread throughout the day, in conjunction with WW posture, slowly and deliberately, for a few weeks. Your pelvic floor muscles might need a bit more work, just to get back up to scratch again. Others will probably disagree with me. If it works, it works, if it doesn't, it doesn't, but you will never know if you don't try it!

Just remember to measure your progress by quantifying the leaks and their changes. In WW posture you won't get much movement out of your pelvic floor because it is already stretched tight by the posture. You may think they are not working, but they will be! It is the correct action, not the amount of movement that counts! Get a good women's health physio to help you get started if you are unsure whether or not you are doing them right.

Louise

Hope this helps.

I'm still confused about the benefit of kegels. I understood from Christina's book that they do not really help POP and, in fact, can make it worse unless performed with the body in a ninety degree angle. Is that correct? Can kegels support the Whole Woman workout and posture? If so are they beneficial for a rectocele?

Mag

Hi Mag

You are right. There is no research that has shown that Kegels will help POP, because Kegels exercise muscles, whereas POP is caused by stretching or breaking of the endopelvic fascia, which is like a thin web of ligament tissue that holds our organs in correct relation to each other. Depending on the technique used, they can make POP feel worse.

The trick is to do them in Wholewoman posture, which pulls the organs up and forward, so they are not resting on the pelvic floor. If you do Kegels with the pelvic organs resting on the pelvic floor the organs can be so low that they will be below the deep pelvic floor muscles, and squeezing the muscles around the bladder, vagina and rectum can squeeze too high up and force them downwards and risk doing more damage to their fascial supports.

The 90 degree angle Christine is referring to is the angle between the sacrum and the vertical, ie keep your lumbar curve large and your belly relaxed so your pelvic organs can roll forwards onto your pubic bones and away from your pelvic floor, which will be basically diagonal and out the back, not horizontal and underneath.

Don't tuck your butt under, or do them while slouched in an armchair. It is the c-shape that is dangerous. This moves your organs backwards, and they will fall down, making Kegels risky.

Re "Can kegels support the Whole Woman workout and posture? I think you are asking if they are useful when used alongside the WW workout and posture. Yes, they can be helpful in reestablishing awareness of where your pelvic floor muscles are, and what they can do. I would regard them like having a stretch when you first wake up. Something you do to just get your pelvic floor moving.

Re "... are they beneficial for a rectocele?" They are indirectly beneficial if they make the sphincters around your anus more responsive. This will make bowel emptying go more smoothly, and improve bowel continence, ie the messages will be conveyed more efficiently. The rectocele is an injury to the fascia between your rectum and your vagina. The vagina is muscular, but not in a 'pumping iron' sense. The injury is to the fascia between the vagina and rectum and/or or to the muscles of the perineal area. If a muscle is intact it can contract effectively. If it is damaged, or reduced in size it will not be able to contract efficiently, but it is probably more important to have the remaining muscle tissue working efficiently, as long as exercising is done in a way that does not cause futher damage, as above.

It sounds counterintuitive to bring the rectum forwards, ie isn't that the problem? What you are really trying to do is to rotate the bladder, uterus and bowel up and forwards. If you can rotate the bowel forwards, and out from under the sacrum, the top of the vagina can settle back into the space that is left and prevent the rectum from being squashed downwards from above.

Does this make some sense?

Louise

So Kegels can be useful in getting the pelvic floor muscles moving again, particularly after pregnancy or years of poor posture, but are not by any means essential.

First, THANK YOU, Louise! I so appreciate your clarification of Kegels.

Next concern, actually fear! While splinting today, two things happened. My bladder emptied as though being squeezed, and I noticed blood from my vagina on the toilet tissue. I checked to be sure it was from my vagina. I am ten years into menopause and have never had bleeding. My last check-up was 17 months ago when I had a smear and ultrasound. The bleeding was faint and light like the beginning of a period, but definitely there! Can pelvic issues cause bleeding? I'm so scared.

Hi Mag

If you are ten years past menopause and using toilet paper to splint, I would think thin vaginal walls would be the cause of the blood. If you can stomach the idea, I would suggest not using toilet paper because it is so dry and could adhere to a sticky vaginal wall, and damage the surface when coming away.

Emptying your bladder does not surprise me because you are moving your bowel when you splint. If there is pressure on the bladder that is suddenly lifted, and you are creating different intraabdominal pressure (with a digit in your vagina). In addition to this, the splinting is straightening your rectum out, so the stool is probably moving into the extra space and relieving pressure on your bladder.

I wouldn't worry about it unless the bleeding continues, in which case a visit to the doctor should put your mind at rest, or investigate the bleeding. Try a vaginal lubricant to help your vaginal tissues move over each other more smoothly. You could put a bit of lubricant on the toilet paper as an alternative to not using it.

It can be scary having to learn stuff about our bodies, and having our bodies do things that have not happened before. Hang in there. You will learn a lot more before you leave Wholewoman!

Louise

Louise, your insight and advice are so helpful and encouraging. MANY THANKS!

I splinted with my finger, but cleaned with toilet paper noticing the blood. I am dry and will try a lubricate before splinting the next time.

Mag