Choosing between surgery or physio, what should I do?

Women's health
1

Dear ladies, I have some news about my rectocele and I need your advice, hope you can help me to decide.

I had cystocele and hysterocele surgery 5 months ago and after surgery I have developed a rectocele. It is mild but I have problems in the bathroom and feel like a ball in my rectum constantly. 

I went to my check last week and my gyn confirmed that I have a rectocele. He saw also some stitches inside my vagina. He told me to have surgery for the rectocele and he would remove the stitches in the op also. He told me not to worry, he would use stitches for the rectocele repair (not mesh).  He scheduled the op for June.

Well... the following day I had an app with my physio who said "DO NOT OPERATE THE RECTOCELE!!!". He explained that my rectocele is mild, he is sure that I can fix it with rehabilitation. Rectocele surgery has bad results, he said, and many problems afterwords with sex. Is that true?

It is the same situation I lived two years ago, when I began to feel the cysto and hysterocele, the physio said not to operate, but after 1 year physio treatment, finally I had to operate. 

What do I do? . I do believe in physiotherpy, but as a complement of surgery. For my experience, I don't believe in it as a substitute of surgery. Should I postpone the op, do the physio treatment and see what it happens? Or should I operate now? It would be very stressful for me to have like a year of treatment just to have the surgery finally. What do you think? Hugssss!

2

Hijadeonagro the physio had no right to disagree with your consultant. It was totally unprofessional. Your Urogynaecologist is the expert in this field and although your physio may be a specialist physiotherapist in urogynaecology she doesn't have the same experience or training. To be honest I'm disgusted!!!

3

It could all be down to money. If you had surgery you wouldn't go for physio.

Physio can be expensive also hun.. Doesn't sound professional telling

You that. Good luck xxx

4

Hi,

 I remember you had surgery the same time as me  and just want to say  I feel so sorry for you. What a nightmare situation. I didn't even know I had a rectocele as went for a severe cystocele but they said it was mild  but they would repair everything at once so it was all done and of course I feel great now and I'm so grateful. I can't believe all these muddling situations  we read on this forum and  now such contradictory advice from experts , it's so hard for you to know who to believe or how  to decide what to do for the best.

 I think you could ask for a second opinion if that was easy or cheap at all. Are you in England? Otherwise you'll just have to go with your gut instinct  but if you  are already uncomfortable it would seem- and of course I have no idea – that it's not going to get much better and you'll end up having the  operation so maybe just best go for it and start again.  I know when I went to see my consultant  at first and they explained what they wanted to do I was quite shocked  as  it was the three things ..hysterectomy as well ..and I said can't there be a simpler repair and they said no,myou'll just be back again later . It was then I asked for a second opinion and managed to get one  with a very experienced urogynaecologist who said the same thing - you will just be back, all the problems are connected, best do it once and for all and it did seem to make a lot of sense .

 I really feel for you and wish you all the best with your decision and the outcome .

5

Dear Matron Im disgusted too, The physio is the President of the Spanish PF Physiotherapist Association (he is a man, I used to go to a physio woman but I had to change cos she was very far from my office). Given his position he should have been more professional, but I have to say that I expected that reaction, here in Spain physios don't tend to support surgeons... It's a shame Matron... I'll keep on doing physio because I think that the stronger my muscles are, the better I will be for surgery but I'm very disappointed. Thank you for your professional view on this.

6

Thanks Welshgirl, no problem with money, I'm covered by my insurance in case of surgery and physio treatments are not too expensive here... So money isn't an issue... Yes I agree with you it didn't sound very professional for me eather... Thanks for answering!

7

I think you are right continuing the physio and you are absolutely right it will make your pelvic muscles stronger and therefore give you the best chance of successful surgery. Sorry I forget you are in lovely Spain where things are slightly different. I'm sure you will make the right choice when the time comes.

8

What I mesdnt hun was on the physio side of things for her or him its money for them if you didn't go for surgery and jusdt have physio does that moasks sen

There is as lot of money to be made by them if you didn't have surgery.. Your urogynacologist will know the best when it comes to prolapse.xxx

9

Hi matron,sorry to change the subject. Do yuou think its too soon yet for pelvic

Squeezes.. I'm 12 days post op?xxx

10

I usually advise you to follow your consultants advice but obviously he can't have mentioned anything. You could gently try now and see how you feel otherwise wait another week xx

11

Oh yes in think he said ,4 wks,it just came to me now.. I'll wait till then and start.xx

12

Hi Hijadeonagro,

I might be wrong but if you are still pre- menopausal you mat still have good strong ligaments and therefore physio may work well if only a mild.

If however you have been through the menopause and therefore ligaments are weak then physio may only help as compliment to surgery.

Hope this helps,

If we could only see ahead and know what would be best!

You may be able too tell if phisio is improving things right up till just before the op and decide at that point.

Good luck whatever you decide!

Phyl 💖

13

Albee, how long ago was your operation please?

14

Oh Welshgirl I understand now!

15

Hi Alybee thanks for your words, I'm glad to read that your surgery went well! I didn't have the rectocele when I had surgery, it has developed later. As for a second opinion, my gyn is one of the best in this field in Spain so I wouldn't know to whom ask for it...you are right, I agree with you sooner or later I will have to do the surgery...and of course it's everything connected down there... The good thing is that my hubby supports me in any decision I make. Thanks darling!!!! 😘

16

Hi  again,

 of course you are in Spain  and all different.  It is great your husband will support you that's the main thing. It's interesting you're seeing a very good specialist, probably then what he says is correct, that's what I would think anyway ..you will know which decision to make in time and as someone else said if you start the physio you can tell if any change at all  but perhaps not best to cancel the  op yet.  That is so awful that something else  should develop so soon and so suddenly after all you've been through. I guess I was lucky mine was so bad to start with in all areas! 

 let us know how you get on. All the best.

17

Hi Phyllis, I'm 46 not menopause yet...

You had a good idea, I'll have two months before surgery to see if physio improve things a little bit... I have an app with my dr the first week of June to discuss the surgery, I'll speak to him sincerely, I'm sure he will give the best advice I'll go with my hubby because I always forget to ask the most important questions ☺️

18

Write down a list of things to ask.

Hope things improve for you.

Phyl 💖

19

Yes Alybee in fact I went to the anesthetist already...

😘

20

Hi,

I'm in much the same situation except my anterior repair & hysterectomy was 3 years ago. My mild rectocele is worse probably because the bladder was supporting it before. I was told they do not operate on small rectoceles because "you would not feel the difference" and would not do it at same time as other surgery as it would "make you too tight down there". Well I'm sure once there is more room the rectocele is quite likely to get bigger. I have done everything I was told:-

1. Don't get constipated

2. Don't strain

3. Do pelvic floor exercises (I bought one of those Kegel things). This won't make your prolapse go away just stop it from getting worse.

I don't know if I should go for the surgery or not? I feel as though I've only just recovered from the previous one. Personally I think if it's really causing you regular bathroom problems then maybe it's time to have it done. It's just the thought of it making things worse isn't it? My pelvic floor doesn't seem very strong at all so I'm keeping going with the exercises for now. I get so worried about bowel control after the op!!!