Rectocele prolapse diagnosis - help! :(

[Anonymous]

Hi there,

I am four weeks postpartum after my first child and was just diagnosed with a rectocele by my OBGYN today. I had noticed an abnormal bulge in my vagina, and suspected that's what it was, but I was still pretty traumatized to hear the official diagnosis. I have a referral appointment with a pelvic floor specialist doctor in a few weeks, but I have a lot of questions that my OBGYN didn't really answer. Plus I've been googling rectocele on the internet (never a good idea, right!), and I'm getting kind of freaked out by some of what I'm finding.

At any rate, some questions for any of you who dealt with rectocele or other organ prolapse, would be great to hear about your experiences.

--Can you still exercise normally? I see posts on other websites from people who stopped major heavy lifting and strength training to prevent the condition from getting worse. I like to stay fit and getting back to strength training with weights (free weights, weight machines, plyometrics, yoga/pilates) was one of the biggest things I've been looking forward to postpartum. Exercise is a major stress reliever for me, and having to adopt a "gentle" exercise routine for the rest of my life would really crush me.

--On a similar note, what about the heavy lifting? I'm an RN and work 12 hours on my feet including moving heavy or obese patients around in bed... is that going to make my condition worse?

--How is sex with rectocele? I'm not far enough postpartum to have sex again, but now I'm really terrified about how it's going to feel for me, and for my husband... this is so embarrassing!

--Has anybody had rectocele repair, and was it worth it? I'm afraid of complications from the surgery leaving me without an improved quality of life (e.g. painful sex, unable to lift heavy object, etc.)

Please share your stories and advice if you've been through something similar.

Thanks!

[Anonymous]

I don't have any experience with this, but I had other postpartum complications. Try to remember that you're more likely to get overly upset about this news because of the hormone shift. Just take it one step at a time.

[Anonymous]

Good advice!^^
I would also suggest taking this list of questions with you when you go to the specialist.

In general, anything that makes you strain may exacerbate the problem, so it might not be a bad idea to stick with low impact exercises, no heavy lifting, and make sure you don't get constipated.

When will you go back to work?

[Anonymous]

OP, I was diagnosed with a rectocele after my DS was born. I too noticed a small bulge but didn't have any other symptoms. Fast forward to weaning at 12 mos postpartum and I have zero issues. Can't even find bulge anymore. Apparently breast feeding hormones exacerbate the situation. I will need surgery eventually (not mesh) but won't do it until after I'm done having kids. I don't know what a subsequent pregnancy will mean for me and how I will manage that (a pessary maybe?) but I have had no issues exercising since I started up around 8 weeks postpartum.

Anyway, all this to say that I too was pretty devastated by the diagnosis but pleasantly surprised at how much better things are with time and hormone changes. There's hope!

[Anonymous]

PP, thank you for the feedback! I don't know how bad my rectocele is, but I'm guessing it might be a stage 2 by some of what I've read. Was yours visible at the entrance to the vagina? I can feel mine there and yesterday after the diagnosis, I finally made myself look down there and it is definitely visible, especially if I bear down (makes me terrified of sex, especially oral sex!). I am breastfeeding, so your post makes me optimistic that it will recede when I wean, but I don't know by how much it will improve

[Anonymous]

I have had a prolapse for 24 years. No complications. No limitations.

[Anonymous]

I've had a rectocele for many years, following the birth of my now-16-year-old DC1. It did not cause any particular problems during my pregnancy with DC2, nor did the situation appear to worsen after DC2's birth. My GYN describes my rectocele as "moderate." It may worsen after menopause, it may not.

My rectocele was more severe and much more bothersome during DC1's first year. I did not have a period until DC1 was 13 months old, so my estrogen levels were very low and my OB said my vaginal tissues were very dry and thin, which exacerbated the rectocele. (Sex was very painful for me during this time, too, although not related to the rectocele but more to the thin/dry tissues.) Once I started my period again (even though I continued BFing), things rapidly improved in all ways "down there," LOL. So IME, there is no way to evaluate your situation so close to having delivered, especially if you are breastfeeding. Also your muscles and ligaments may not have had enough time to recover. It is quite likely that your rectocele will improve at least somewhat over the coming months.

(Also, despite the fact that I didn't get my period until about a year after DC2 was born, I did not have anywhere close to the same rectocele/vaginal tissue issues after DC2's birth.)

re exercise--I don't have experience with weight lifting, but I have no problems running or doing yoga. My rectocele is always more noticeable when I am constipated and right before my period starts, but I am still able to exercise.

re heavy lifting--I don't have this kind of job, but I did have some trouble with heavy lifting during DC1's first year. I don't think it made the rectocele worse, necessarily, but I was very aware of the rectocele when I lifted things during that period. No trouble with heavy lifting now.

re sex--I have had no troubles related to the rectocele--no pain at all. I can't feel anything different because of it. I really don't think your DH will feel it either. (Things might "feel" different to both of you, but I don't think that's because of the rectocele.) Also, your rectocele and resulting "bulge" are exacerbated by gravity--it is much less apparent when you are lying down.

re repair--I haven't had surgery obviously and feel no need for it, although my GYN has told me that often a rectocele worsens in menopause, so perhaps I will consider it in the future. I will say again that I think it is much too early for you to be thinking about this.

After DC1's birth, I was tremendously upset about this development. But given some time it became no big deal. Try not to obsess about this too much. Even if you continue to have problems and opt for surgery, you will be in a better frame of mind about the whole thing in a few months or a year. The PP who noted that you are more likely to be overly upset because you are hormonal is absolutely right.

Whatever I am doing, my rectocele is always, always more noticeable when I am constipated. Drinking lots of water, eating lots of fiber, etc, really really help. Also, if I do get somewhat constipated, when I have a bowel movement I usually insert 2 fingers into my vagina and press back against the bulge; it really helps. (TMI!)

[Anonymous]

Bump - NP here. I have a rectocele, cystocele and a prolapse. Has anyone else dealt with all three?

[Anonymous]

OP here - Thanks to those who replied so far. It's really helping me and I am realizing I shouldn't get too worked up about this at this still early stage postpartum.

More stories would only help if anybody else out there has more experiences to share. Including those with other or multiple forms of prolapse, per the previous poster's request.

[Anonymous]

OP and NP, I have a rectocele, minor cystocele and other issues following a forceps delivery over 2 years ago. My rectocele is rated "moderate" whatever that exactly means. I have difficulty having a bm because of it, and am seriously considering surgical repairs. I think it may be exacerbated by the damage to the vaginal opening and pelvic floor from delivery. I only recently received a referral to a colorectal surgeon, and I would recommend seeing one if you have problems similar to mine. I feel like I am only beginning to understand what may lie ahead of me in terms of having anything repaired. Like the PPs who said that things change after you wean, that couldn't be more true. I saw some improvement, but not enough to make me feel normal. Everyone is different and you may be fine in time, or at least feel like you can live with what your situation is. I can't speak (yet) for the impacts of the surgery, but I can tell you that I am also very active and it will benefit you tremendously to resume your fitness routine...in due time, and at a pace appropriate for your recovery. In the meantime, seek out a good PT who can help you work on both your pelvic floor and retraining your abs. Pilates is great, but you may want to wait until you have done some work to retrain your tansverse abs, or find an instructor who is skilled with postpartum women.

I, too, would love to hear from anyone who has had surgical repairs. It sounds like there are at least a few of us in this boat and I don't know of anyone, personally, who has been through this.

[Anonymous]

I have a recotocele and it's not improved in 4 years. I have no issues with my bowel, but my bladder is jacked. I have to urinate every 3 hours at night- which I have found to be disruptive to my sleep. I also have to urinate constantly which inhibits me from taking long walks, etc.

I know of two people who have had repairs and said it was a nightmare- with the mesh in particular. I have been told that the repair works only once- and you need 6-8 weeks of ZERO lifting to heal- not practical with young kids.

I have also found that sex has never felt the same. Everything just feels off.

Sorry to sound so depressed, but it hasn't improved for me and I will definitely need surgery for my level 2.

[Anonymous]

4 weeks PP is too soon to be exercising in any case. Once you are cleared for exercise, I would try something non-impact like swimming.

For the prolapse, definitely follow up with a urogynecologist not just a regular ob/gyn. Breast feeding can keep everything lose, so see the urogyn after you wean.

There are pessaries as well as PTs who specialize in pelvic floor.

[Anonymous]

14:51 -- I have all three and felt devastated at 3 months PP. Now it has been a year and I have a pessary and feel fine. Try to relax and give it some time. I am also still Breastfeeding, so it might get even better--that would be nice, because the pessary can move around and I have to remove it for sex, but I can live with it. I don't want surgery and don't think I need it. Get a couple opinions (not just from a surgeon!) and good luck to you.

[Anonymous]

20:19 again -- I exercise daily and lift weights. Until I got the pessary, I couldn't walk without feeling odd and uncomfortable. Now I can jump rope, etc.

[Anonymous]

OP, I have a rectocele. Have never seen a specialist. Once you get there, a lot of your questions can be answered more specifically. I guess mine is moderate, or mild? I don't know, the midwife who told me it was there after my second delivery didn't make a big deal of it and told me to do lots of Kegels and avoid constipation.

I don't do heavy weight lifting but have never noticed an issue due to running (up to half-marathon distances), biking, free weights, etc.

I was also working as an RN and doing 12 hour shifts up until a year ago. No issues.

Have not even considered surgery. If it ever gets worse, I might.

I've asked my husband if sex feels different, and he says no.