Pregnancy/ultrasound problems with rectocele

I have never ever heard of a rectocele this big. Mine gets to be the size of a half walnut (in the shell) at it's largest. What the heck? I can't know- but I would have bet on the fibroid/tumor diagnosis. I'm surprised to find out a specialist does not think this is the case. A mass that grows and grows over time does not sound like a rectocele to me (anyone else have a different experience?)
Now let me think aloud. If your rectocele is this size it's because it's full right? There is no way that it can be that big without something dilating the lower colon. That something would have to be poop. Do you feel like you are able to fully empty your bowel? You probably have to splint to do so (support with your fingers inserted in your vagina) right? But if it's that much poop how in the world can you get it out without stretching your rectum terribly? I know it's extremely personal- but really valuable information if you are willing to give it.
I want to jump up and down for your recent good news- that a vaginal delivery is possible. Do you trust your most recent diagnosis?
Advice? Geez, I don't know. Have you felt the mass? does it change after you use the bathroom? That might be something to check.
As far as the birth goes, how are you planning to birth? Home, Birthcenter, Hospital? Have you thought about positions? Hands and Knees is good. Water-birth is especially comfortable.
As for healing postpartum, our advice here is to wait at least two years before even considering surgery. There is a great deal of healing that goes on in the first few years postpartum.
Get back to us and let us know some more information!
and congratulations on baby number 2!

ouch ..soon to have 2...

i too have suffered w/kidney stones and
i feel for you...

were you able to pass them ?

i had to have a ureteroscopy the lst
time....i have been taking some
homeopathic spray that seems to be
helping me pass smaller pieces of gravel
rather than the whole shebang at once...

be well..

warmly.....susan

Here's what you might want to do....look at a number of sagittal views of the female pelvis. You can also google pregnant sagittal view. I'm trying to noodle out how in the world your baby's head can push the descending colon progressively out more and more. To do this your vagina would have to feel totally blocked off by the baby- no place for fingers to go at all.
Not sure I have this right. But it still seems very very weird to have a bulge that large that is increasing in size on ultrasound.
Now, the rectocele you describe as soft and passing normal sized stool seems pretty standard, oh and also pretty responsive to improvement attempts! And that's good news. Rectoceles get really bad when the colon is permanently dilated- unable to shape the waste product well and so it all piles up there- distending the colon more and more. Doesn't sound like you are dealing with that.
Pushing the bulge in when going to the bathroom is also a pretty standard procedure at times. Though once you get your rectocele sorted you may find that you never need to splint again!
Here's my opinion about vaginal birth: If you can have sex and you can put your fingers in there and you can go to the bathroom with no problems- and if you can be on your feet and move your body then *you CAN have your baby vaginally* why the heck not? :) Seems like the doctors you are dealing with are making quite a big deal over not a whole lot....(if what you are in fact dealing with is a just a rectocele).
Another thing I would do if I were you is read about the birthing process- what happens in the body- how the baby moves down and out. Knowing about this will help you understand that a rectocele will be pushed out of the way by the baby's head as easily as you can push it back with your fingers. It will not get in the baby's way. I promise. The Bradley method childbirth books do a pretty good job describing this process. You will be way less unsure of the safety of vaginal birth with a rectocele if you understand how the birth actually happens :)
and of course surgical births are statistically way less safe and have way way more complications than vaginal births. The last thing you want when you have a rectocele is to cut through the supports for your uterus. A c-section will cut your abdominal muscles and cause a good bit of scar tissue. It also makes it very challenging for you to take care of your toddler for a good 6 weeks on average.
If you have not seen 'the business of being born' you might like to watch it and 'orgasmic birth' is pretty inspirational and entertaining as well.
Constipation is the absolute worst thing for your rectocele and can certainly lead to one. Do everything you can to avoid it. We have had many discussions here about that and how to avoid it- use the search box and you will find out more than you ever wanted to know. Also worth a search is the Lo-poo or maybe it's Loo-Poo. It's a technique for encouraging bowl emptying with no straining.
If your prolapse didn't bother you much before your pregnancy I can assure you that you will be able to manage it beautifully after the pregnancy with no need for surgery.
I'm about 31 years old and about 30 weeks pregnant with our 5th child. I found out about my prolapse after our 3rd was born but it was there after the second child was born, I just didn't know what it was. Our 4th pregnancy and birth did not make the rectocele any worse- and the 5th pregnancy has not so far (all vaginal births by the way). Now, I must tell you that it did get a bit bigger (from a grape to a walnut) during the last pregnancy and this one too. And also my anterior wall softens a great deal as well. But my symptoms improve after each birth for about a year until I hardly know I have a prolapse and only find it if I go looking. This last postpartum time I was able to get the rectocele to reverse so much that most days it was simply a weak spot on the wall- no bulge.
There are a number of women here who are living well with a rectocele. We are not willing to take the risks surgery offers and instead have made many lifestyle changes.
Many Doctors offer a surgical fix because they think you want one and they genuinely want to give you want you want. Women here have reported many times that after telling the doc they don't want surgery, the doc is relieved and goes on to say things like "at your age it's not the best idea" and "you will need multiple surgeries in your lifetime" and things like that.

I must say that I'm having trouble picturing this too. I would think that a rectocele would reduce substantially when you lie down, as in an u/s, and would be very difficult to assess for size and increase in size. That is why so many clinicians miss a prolapse during a lithotomy exam. But then, I am not trained in reading u/s. Have you had any kind of standing exam? I will be interested to hear what your second opinion turns out to be. Until then, best wishes for the remainder of your pregnancy and your birth! You'll do great! Oh, and my opinion is to wait at least 2 years post birth before judging the state of your body. For me, at two years pp and having done this work, my cystocele is practically non-existstant and has zero impact on how I live my life.

I totally agree with previous posts....alemama, you have outdone yourself this time!
Bad_mirror, yes, it is not making sense. Soon to be 2, why did you have the ultrasound to begin with? Was it because of the football reference from your husband? I don't think there is any way a rectocele could increase as you are describing, at least without massive bowel impaction. I disagree with the idea that the baby's head is causing increased pressure and worsening bulging. If this was the case, you would be symptomatic, which you don't seem to be.
I would really recommend investigating what is happening in your own body, for yourself. Your fingers will be able to assess a heck of a lot more than an ultrasound in many ways. What have you felt?
Kidney stones are so painful. There are many ways to be pro-active about self-healing and keeping track of their presence on your own, as well ;)

please please please...
re the keep track of their
presence on our own...

i have changed my diet completely..
waaaaayyyyyy less sodium....waaaayyy
more water......do take some homeopathic
remedies but am always interested in
what others know...

thanks in advance for the info...

warmly........susan

I think we need to be clear that there could be at least two different ways that there can be a big bulge between vagina and rectum. One would be that the rectum is distended, which would make passing normal shaped stool unlikely. The other is that the large intestine, and maybe even some small intestine could come down under the sacrum and into the space between the rectum and the vagina if the rectovaginal septum is damaged. Rectocele doesn't necessarily mean that the rectum is grossly distended, does it?

I think you should seriously consider the position that your doctors do not really know what is going on, probably because they are relying on scans, instead of getting their hands out and placing them on your body for a thorogh palpation of what they can feel. If you can find an old doctor or midwife who examines patients thoroughly with her/his hands, possibly with their eyes closed, then you might find somebody who can tell you what it is. As the other Members have said, there are too many things that do not make sense. IMHO, these guys are positioning themselves for an a*** covering diagnosis, so they cannot be blamed for being bad diagnositicians and anatomists. They are thinking of the worst case scenario hoping you will be scared into going somewhere else because they are out of their depth. I hope it all turns out much more simple than they think. You have plenty of time to find out, whereas they are suffering from 'terminal lack of curiosity' and are not going to help you get to the bottom of it, even if you have to play "Talking Heads" to find out.

Such uncertainty, when you just want to enjoy your pregnancy, is really unpleasant. I do feel for you.

Louise

Hi Soon

I just had a conversation with a very longstanding friend of mine who had four babies and carried an enormous fibroid through the last two pregnancies. It was quite low, and ironically had the beneficial effect of keeping her cervix closed, when she had needed a cervical suture for the previous (second) pregnancy.

The fibroid did grow enormous during the third pregnancy and shrank right back after that, announcing her fourth pregnancy as an enormous lump in her belly before she even knew she was pregnant. She subsequently had an hysterectomy, with loss of one ovary, at the same time as the fourth birth (third planned CS), because of the risk of bleeding. Haemmorhage during pregancy is also a risk, but I don't know what size risk. You really should take your doctor's advice on this bleeding risk if indeed it is the same type of fibroid as my friend had.

BTW, my friend had normal menopause at the normal age, and has not had any prolapse or incontinence problems, apart from the postpartum problems after a very difficult first vaginal birth.

So, yes, some (all???) fibroids do grow enormous during pregnancy because they are fed by pregnancy hormones (according to her obstetrician) but they do shrink afterwards. The Ob was very concerned that she had a fourth pregnancy, full stop, but it went to the normal 38 weeks for a planned CS, even though he said the fibroid was twice the size of the baby.

It does seem strange that your doctor cannot be certain what is really happening. Perhaps that is part of the language they use to guard themselves against litigation? It is a bit hard on you though. You could ask for another opinion.

I cannot see why you would need a repair of the rectocele, especially so soon after birthing, right in the middle of lactation, looking after a baby and a toddler, and before your body has had a chance to do all its own healing and reversion. I would just concentrate on getting through the next few weeks and getting you and the baby safely through the birth. Then give your body two years of Wholewoman techniques to get it to revert properly and see what degree of rectocele you have at that stage. I suspect that, by then, you will be managing it quite well and be not really interested in having surgical repair. That is all a long way down the track.

Louise

That is great news, Soon. Let's hope they have it right this time. I have always found that doctors assume the worst case first, and try and prove it. If they cannot prove it they move the diagnosis to the next most benign condition. I am not being cynical here. It is much better to have a death sentence first, then have it disproved and end up with something far less serious, than it is to assume it is something minor and treat that, only to have a life threatening condition worsen because it is not being treated, and get a nasty surprise.

But it does put a pregnant woman through a lot of worry, just because the doctors are not investigating thoroughly and communicating with each other.

Anyway, it sounds like this last few weeks will be pretty good now. Hope it goes well for you, and that you have a smooth and safe birth. Keep us posted. It is always exciting when a new WW baby is on the way! Take care.

Louise