# Rectal Prolapse/Rectocele/Enterocele



## smason (Jan 7, 2002)

After 6 months of severe difficulty eliminating stool and gas and a constant feeling of rectal fullness and numerous doctor visits and tests (including colonoscopy, pelvic ultrasound, & abdominal CT scan), I may have an answer to my problem.I finally ended up having a defecating proctogram at Mayo Clinic in Rochester last week. The x-ray showed I have a rectocele and an enterocele. It also showed that my pelvic floor had dropped considerably. The next day I went back for a follow-up with the GI doctor who ordered the test. He had a colorectal surgeon look at the x-ray and examine me. Besides the rectocele and enterocele, the surgeon diagnosed rectal prolapse. Apparently this is seen quite a bit in women who have had hysterectomies. (I had a vaginal hysterectomy in 1997.) I am scheduled for an abdominal rectopexy late next week. The surgeon will be removing about a foot of my sigmoid colon and pulling all the sagging intestines up out of my lower pelvic region. The rectum will be pulled up to normal level and sutured to my backbone. Supposedly this surgery will also correct the rectocele and enterocele. The surgeon said there is an optional approach to the surgery involving going in through the rectum, but he says since my pelvic floor has dropped so much this sort of approach to the surgery would have more of a chance for recurrence of the prolapse.I hope this is the answer to my problems. I have a very active colon (no colonic inertia here), but I have been having a nearly impossible time eliminating stools from the lower intestinal area. According to the surgeon, the rectal prolapse contributes greatly to this condition.Does anyone on this board know anything about this rectopexy surgery? If so, I'd appreciate your comments.Thanks,Sarah


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## Kathleen M. (Nov 16, 1999)

http://www.muschealth.com/ddc/surg/rectdes.htm was a site I found...but it sounds like the doc told you most of that.K.


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## stprdi (Apr 30, 2002)

So what all was happening with you to get the diagnosis? I had a rectocele repair about 4 years ago. Then a bladder suspension a couple years before that. Since I have had this possible IBS-constipation, I have wondered if the backup of BM has damaged these surgeries. I also have a hard time getting it out. It seems like I loose the necessary push the further down it gets. Course the doctors all say they don't think it's a problem. Good luck to you.


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## smason (Jan 7, 2002)

stprdi,I have been having this horrible blocked feeling in my lower colon/rectal area for six months. At best it felt like I had a brick weighing down the rectal area and sitting was very uncomfortable and standing was uncomfortable. At the worst times I had severe cramping and inability to move stool or gas out of my body. Also, I have urinary tract discomfort and more urinary tract infections than I had ever had before.My diet became more and more restricted to the point where I can only eat very light meal and nothing gas producing. When I eat, my colon starts it's normal reaction and then the waste or gas cannot exit my body.The first time I saw a doctor about it I was in the mere discomfort stage where it felt like a brick was in my rectum. I tried to explain that I felt like something needed to be pushed out, but no amount of pushing was getting it through. I told the doctor I was so desperate that I got on my hands and knees with a mirror to see what was pushing out of my body. I told him I could swear I saw a reddish sausage sort of protrusion pushing out of my rectum rather than the feces I expected to see. He did a digital rectal exam and said he thought I had a fairly good sized rectocele.He told me I should have a colonoscopy to see what else was going on. The colonoscopy was fine. The general surgeon who did the colonoscopy told me that his digital exam did not result in finding the rectocele that the GP thought he found. However, the general surgeon thought he felt a cystocele. The GP then did a thyroid blood test to see if I had an overactive thyroid since I told him my body reacts quite quickly to any food I ingest. The thyroid test came back fine.An abdominal CT scan was done, which came back pretty normal other than indicating my cecum was lying low in my pelvis rather than in the normal appendix area.A pelvic ultrasound showed no abnormalities. A GYN said there was a small rectocele, but he felt if I had rectocele surgery I would still suffer from the same symptoms. The defecography (or defecating proctogram) showed the rectocele and the enterocele. The surgeon who reviewed the x-ray talked with me and then had me sit on a toilet and lean forward and push as though I were trying to have a bowel movement. He instantly diagnosed rectal prolapse, which is exactly what I thought was occurring way back when I saw the protrusion from the rectum with the mirror. The surgeon said that the rectal prolapse surgery would take care of the rectocele and the enterocele. I'm hoping this surgery corrects alot of my problems so I can eat normal again and eliminate like I did for the first 42 years of my life. Even though you had the rectocele repair, I would inquire about the possibility of rectal prolapse. I hope this information was helpful.Sarah


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## smason (Jan 7, 2002)

kmottus,Thanks for putting that website on this post. I found it some time ago also, but I've wanted to read it again since my diagnosis and I couldn't find it.Thanks again,Sarah


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## Tiss (Aug 22, 2000)

I've been having this weird spasm sensation in my rectum (feels deep) after sex and even just sitting. I was diagnosed with a rectocele in Jan 2002. When I have a BM there is a big bulge out of my rectum. The doctor said it shouldn't be a problem, but that I need to keep all stool soft so it can easily pass through. About 2 weeks ago I noticed I was having problems inserting my estrogen vaginally with an applicator. It would only go about half way up my vagina and then stop, like there is something in the way or a sort of obstruction. So today, I manually stuck my finger as far as I could into my vagina and on the back side (inside the vagina) I felt something hard and nobbly-like something is pushing against the vaginal wall -it's really hard to explain. I think maybe the rectocele is worse and maybe the rectum has prolapsed?? I'm sort of freaked out. I called my internist and made an appointment for next week. Now I'm getting freaked out that it may be a tumor or something. Anybody had anything like this before?? Thanks, Tiss


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## stprdi (Apr 30, 2002)

Yes, that's what happens to me. Before I had the rectocele repair I would get bulging in to my vagina and also a large bulge out around my rectum. I could put my finger slightly in my vagina and be able to manipulate the stool out the rectum. Sounds awful and I'm sorry for that. So I had the repair and all was well for a while. Now it's back. I can feel the stool through the posterior wall of the vagina. I really think all the straining with the IBS has caused it to reoccur. Fine the doctors saying keep it soft to pass through easily, the trick is keeping it from bulking in to the "pocket" that has been formed by the weak wall. Then it backs up. Thus very difficult to push out.


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## Tiss (Aug 22, 2000)

I saw my PCP today and he is referring me to my gynocologist to see if I need surgery for the rectocele and then also to the colorectal surgeon to have another colonoscopy. YUK! I hate those horrible procedures. I told my Doc that I WILL NOT have another colonoscopy unless I AM OUT COLD. I've had nightmares about the last one. I remembered everything about it including the removal of 3 polyps. So he was nice about it and referred me to a Doc that will put me out for the procedure.


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## smason (Jan 7, 2002)

Tiss,That "big bulge" out of your rectum sounds like rectal prolapse. I have a rectocele also, but the colorectal surgeon who diagnosed my prolapse said that the prolapse is a bigger contributor to my problem than the rectocele. In my case, the rectal prolapse is like a big sleeve pushing out of the rectum with the stool backed up behind it. That's why I have such a difficult time eliminating. When you see the colorectal surgeon, ask him about the possibility of rectal prolapse.Good luck!Sarah


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## smason (Jan 7, 2002)

stprdi,What kind of surgery was done to correct your rectocele? I'm having a rectopexy for rectal prolapse, rectocele, and enterocele, which is supposed to limit the possibility of recurrence of the prolapsed rectum and thus limit the possibility of recurrence of the rectocele and enterocele.Sarah


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## smason (Jan 7, 2002)

Does anyone here have a problem with urinary tract discomfort? I never had many problems with bladder or urinary tract infections prior to this elimination problem. Then in the past 6 months I have had at least 4 urinary tract infections and many times I've felt like I had one when I tested negative for it.I asked the surgeon if the rectal prolapse and the enterocele and rectocele could contribute to this problem. He says it's possible.So I'm curious if any of you have similar symptoms.Thanks for answering,Sarah


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## Olga (Mar 20, 2002)

Sarah--I had surgery to repair a rectocele ### 3 years ago and it caused my IBS/D to go to severe IBS/C. My GI doc said this is very common. Fixed one problem and caused another. In my case the wall of my vagina gave way and my rectum was falling out my vagina. Sounds gross but it happens. I went to a GYN who operated to repair the wall of my vagina and thus support my rectum. Don't know if this makes sense or not. The bad part is I've been told this tends to come back and I may have to have the surgery again in the future. Good luck to you! There are many of us out here who know what you're going through.


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## Tiss (Aug 22, 2000)

So you are saying the surgery caused C??? #### (no pun intended)-I've been dealing with C my whole life and for the last 2 years finally have some control over it! Forget the surgery if it's going to cause C problems again. I'd rather deal with my rectum hanging out! True, we just trade one problem for another! Damn!


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## Olga (Mar 20, 2002)

Tiss--In my case the GI doc said it was "very common" for this type of surgery to cause C. After my surgery I did a complete turn around (and not for the better). At first I thought I was cured because I didn't have the constant D! I didn't know that much about IBS at the time. But after the first year the C just got worse and worse. Now it's to the point that I have to be very careful or I get impacted and THAT does not feel good! My GI doc has given me meds but just says it's just something I'll always have to deal with.







I know there are worse things but I sure wish I could have been warned about this before my surgery.


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## Tiss (Aug 22, 2000)

Thanks a thousand times over for warning me!


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## 13604 (Jun 30, 2006)

> quote:Originally posted by Olga:Tiss--In my case the GI doc said it was "very common" for this type of surgery to cause C. After my surgery I did a complete turn around (and not for the better). At first I thought I was cured because I didn't have the constant D! I didn't know that much about IBS at the time. But after the first year the C just got worse and worse. Now it's to the point that I have to be very careful or I get impacted and THAT does not feel good! My GI doc has given me meds but just says it's just something I'll always have to deal with.
> 
> 
> 
> ...


Hello to all,OK, I need advice here...My colon doc called me today and said that beside me having a rectal prolapse, the defecography also shows that I have an enterocele. He wants me to see an Urogynecology doc for that. I have sooo many questions like:What kind of surgery is best, vaginal or abdominal? Is this type of surgery going to cause C like I read here?What can I expect after the surgery?I also been talking to a surgeon doc and a GYN doc(friends of the family) and the both have different opinions. Don't know what to think anymore. So confused......HELP PLEASE.Anyway, I need all the info, help, advice I can get and for you guys to share your experience with me PLEASE. Can't wait to hear from you all. Thank you so much! Blessings,Abi


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## Tiss (Aug 22, 2000)

Maybe get 3 or 4 opinions from the best doctors you can find. I have not had surgery but I wish you luck. These are hard decisions for sure because we dont know the outcome. Good luck. Tiss


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## 17985 (May 21, 2006)

This post is heartbreaking to read due to the severity of the problems described. I was wondering when issues like this started for folks and what you think might have contributed to thier severity? Thanks.


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## Tiss (Aug 22, 2000)

I believe mine are a combination of chronic constipation since childhood (I am 50 now) and the birth of 2 children.


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## 17985 (May 21, 2006)

I'm sorry Tiss; it would seem then that women may have more of a problem with prolapse than men????


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## SpAsMaN* (May 11, 2002)

Women get more prolapse for sure.What cause the prolapse to reoccured?The constipation?Interesting that the surgeon mention that the way he want to do it may prevent reocurrence.Regarding the brick down on the pubic area,I TOTALLY UNDERSTAND!!!I think in my case that the sigmoid colon can't be lower.







I have to push constantly on my pubic bone to push the stools inside,TALK ABOUT BEING UNCONFORTABLE FROM INCOMPLETE EVACUATION!!!


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## 13604 (Jun 30, 2006)

> quote:Originally posted by Tiss:I believe mine are a combination of chronic constipation since childhood (I am 50 now) and the birth of 2 children.


 In my case, I don't really think having one child was the cause b/c my labor was so easy. My daughter was out as soon as I started pushing. I believe mine is the cause of chronic C for over 15 years. I can remember at least 3 times straining so hard and for so long, worst than in labor, to have a BM. One of those times was last year when I was told about my IBS for the first time. Tiss, why haven't you had the surgery? How do you deal with it? Do you have incomplete evacuation and C b/c of it? Blessings,Abi


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## 16636 (Sep 29, 2006)

is it possible to have a sense of incomplete evacuation without a rectocele, etc.? I have this feeling now that I'm off sorbitol which I took every day for 2 years. It gave me strong urges and mainly diarrhea, but at least I wasn't constipated. Now, on Zelnorm and fiber, I have a string urge but usually only one good cramp in the am and one in the pm. Always feel something's been left in the lower colon but I just don't get a strong enough cramp to get it out. Does this have to be a rectocele or just part of IBS? worrying, Dana


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## Kathleen M. (Nov 16, 1999)

> quote:is it possible to have a sense of incomplete evacuation without a rectocele, etc.?


Yes. It is a common sensation in IBSers. K.


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## UKlady1000 (Aug 12, 2012)

saraheleanor said:


> Does anyone here have a problem with urinary tract discomfort? I never had many problems with bladder or urinary tract infections prior to this elimination problem. Then in the past 6 months I have had at least 4 urinary tract infections and many times I've felt like I had one when I tested negative for it.I asked the surgeon if the rectal prolapse and the enterocele and rectocele could contribute to this problem. He says it's possible.So I'm curious if any of you have similar symptoms.Thanks for answering,Sarah


Hi I realises this is a post many years later but this subject is the reason I have joined the group. I have been diagnosed with rectocele, cysto/urethrocele, poss intussusception and probably enterocele. I get lots of gas and constipation that pushes down onto my bladder and vagina. This undermines the bladder and hurts due to distention of urethrocele. Have you noticed any bulge in your vagina?Thank youVal


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