# I need informations about SOLESTA procedure



## jhonball (Oct 31, 2012)

The anorectal manometry showed a short internal anal sphincter due to his weakness and I think that I must have SOLESTA to cure this damn illness that is $$$$$$ing me the last 8 years. Anyone who had this procedure can help me by telling me his history and the results.

As it is just a gel I will give it a try but I want to hear from others their own stories.

Thanks,

John ball


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## moor_91 (Nov 7, 2012)

http://en.wikipedia.org/wiki/Fecal_incontinence#Perianal_injectable_bulking_agents

try here, and the references on which it is based are good source of info too


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## moor_91 (Nov 7, 2012)

Just had solesta procedure done. I really hope it works this time. There is a lot of swelling again and the seal feels very air tight. It hurts to try and fart even a tiny amount of gas. Sitting on a make shift "hem-cushion" made by forming a towel into a circle on the chair. Don't take any laxatives normally, but going to take miralax for the next week or so from the pain evacuation.

Really had enough of that hospital. All the receptionists and nurses gossiping, normally happy to laugh at my problem, now apparently I "didn't really need any surgery". $$$$$$ing whores...I mean, why do people laugh at this problem and then laugh at you when you are trying to get it sorted too?

last time the solesta worked for me for about a week or 2, then the odor came back. Solesta is a bit like getting collagen injected into the lips to chunk them out. In some people, the collagen doesn't stay and migrates away from the area it is supposed to stay. While the gel is still liquid, it is vulnerable to being degraded by the body. It takes time for fibroblasts to lay down collagen matrix and form fibrous tissue so these lumps formed by the bulking agent will be more permanent.

I really don't know what to do if this doesn't work. I think I will try and get referred to see this guy to get a second opinion about mucosal prolapse/incomplete evacuation. http://www.obstructe...m/Contacts.html


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## moor_91 (Nov 7, 2012)

apparently that word isn't blanked out...


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## jhonball (Oct 31, 2012)

i hope that this time SOLESTA will work for you.how much does SOLESTA cost? wish you the best and keep telling us about you...


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## moor_91 (Nov 7, 2012)

I don't want to talk of the cost...more than I can afford really. Pretty expensive for 4 syringes of gel. I think the procedure would be cheaper without a general anesthetic, no anesthetist fees etc... but my surgeon only does it with a GA. And I know that it failed before, I just need to be doing something always to try and cure this symptom...if you follow


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## moor_91 (Nov 7, 2012)

pengu said:


> I will be going the mucosal prolapse route. god willing we will come upon the cure from different routes.


the pathosis is separation of the mucosal and submucosal layers from the underlying tissues, causing inflammatory exudate (possibly malodorous rectal discharge?), mechanical interference with the pressure zone in the anal canal (effective shortening of the pressure zone due to intrusion of the leading edge of an intussuscpetion/prolapse) and/or reduction in the effective force transferred from peristaltic muscular movements to the stool (obstructed defecation/incomplete evacuation by the dissipation of force vector mechanism)). Who is to say that some of the cases of minor disruptions in incontinence that were included in some of the the solesta case series papers was due to internal mucosal prolapse, and furthermore if indeed filling the submucosal dead space with bio-compatible material that may eventually form fibrous tissue will eliminate the free movement of the superficial layers, fixing them to underlying tissue and eliminating the cause of symptoms? That is to say, maybe solesta is beneficial in cases of mucosal prolapse?

Something we all need to remember is "no diagnosis, no treatment". Need to be logical. You still don't have any evidence that you have internal mucosal prolpase. I think defecography would be the best investigation to show prolapses/intussusceptions. Probably need to go see a coloproctologist/colorectal surgeon who knows about internal mucosal prolapse and get them to examine you.



> 8 years.... I cant imagine.



have you seen the film "there will be blood"? Its kind of like the end of that movie, only without the huge fortune, big house and clubbing to death with bowling ball pin...yet anyway


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## Nakir22 (Mar 4, 2012)

moor_91 said:


> Just had solesta procedure done. I really hope it works this time. There is a lot of swelling again and the seal feels very air tight. It hurts to try and fart even a tiny amount of gas. Sitting on a make shift "hem-cushion" made by forming a towel into a circle on the chair. Don't take any laxatives normally, but going to take miralax for the next week or so from the pain evacuation.
> 
> Really had enough of that hospital. All the receptionists and nurses gossiping, normally happy to laugh at my problem, now apparently I "didn't really need any surgery". $$$$$$ing whores...I mean, why do people laugh at this problem and then laugh at you when you are trying to get it sorted too?
> 
> ...


I wonder if that week or two of effectiveness you reverted to the previous state where there was a lot of bloating, inflamation and "belly noises, those days were you used to strain to keep things in.


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## moor_91 (Nov 7, 2012)

Nakir22 said:


> I wonder if that week or two of effectiveness you reverted to the previous state where there was a lot of bloating, inflamation and "belly noises, those days were you used to strain to keep things in.


When there is pain in the lower rectum you become hypersensitive to the presence of stool in the rectum, because it will push on these painful lumps created by the solesta injections. Also there is sharp pain when stool tries to move into the anal canal. Nothing says puborectalis paradoxical contraction like severe rectal pain.

Before I had the first solesta, the muscles were conditioned to let rectal contents descend into the anal canal , i.e RAIR with no RAER. The rectum also felt like it had fallen into anal canal, and the lumps of injected material effectively lengthen the anal canal.

The fallen rectum, shortened anal canal sensation was more recently improved by electrical training of the muscles


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## Nakir22 (Mar 4, 2012)

That doesn't answer the question, allow me to clarify: in another topic while talking about your case you said that before having gas incontinence (in your younger years) you used to get a lot of bloating, gut noises and inflammation, more than that you thought that those days of straining may have caused the actual condition. My question is in that week or more than you had the full solesta effect did that bloating, gut noises, etc. came back?. Or you didn't get enought time to evaluate?.


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## moor_91 (Nov 7, 2012)

I wouldn't say inflammation. The biopsies showed normal mucosa, but I do get a swollen mouth fairly regularly with lots of foods.

Yes after first solesta I had return of bloating and pain, but this faded over time. When I started TENS a few weeks ago, bloating again returned, and I tend to bloat now rather than leak gas. Then this second solesta has made even trying to break wind painful, this will settle down as time passes.


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## Nakir22 (Mar 4, 2012)

moor_91 said:


> I wouldn't say inflammation. The biopsies showed normal mucosa, but I do get a swollen mouth fairly regularly with lots of foods.
> 
> Yes after first solesta I had return of bloating and pain, but this faded over time. When I started TENS a few weeks ago, bloating again returned, and I tend to bloat now rather than leak gas. Then this second solesta has made even trying to break wind painful, this will settle down as time passes.


I was expecting that kind of results tbh, what worries me is that you will keep getting bloated when the solesta makes its full effect at the levels you did before having incontinence.

As far as solesta goes a temporal patch is obviously better than nothing, but there is a lot of complication to be applied every couple of months for the rest of your life.

One last thing, did you perform electromyography just to check the nerves, it was not on the list of tests you named.


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## moor_91 (Nov 7, 2012)

Nakir22 said:


> you will keep getting bloated when the solesta makes its full effect at the levels you did before having incontinence.


The bloating is nothing like it was growing up and teenage years before odor came, I ate what I wanted back then....now with low FODMAP I know that gas could be almost completely reduced if strict enough. I am just lazy with dieting and food



> As far as solesta goes a temporal patch is obviously better than nothing, but there is a lot of complication to be applied every couple of months for the rest of your life.


I don't think anyone could argue that solesta or similar perianal injectable bulking agents could be repeatedly administered if it continues to fail to give any long term benefit.



> One last thing, did you perform electromyography just to check the nerves, it was not on the list of tests you named.


nope


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## jhonball (Oct 31, 2012)

@moor_91 i suggest you to try as posible as you can to protect solesta and give it enough time to become stabilized so that it can bulk the anal sphincter. for the first month to 3 months.


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## moor_91 (Nov 7, 2012)

jhonball said:


> @moor_91 i suggest you to try as posible as you can to protect solesta and give it enough time to become stabilized so that it can bulk the anal sphincter. for the first month to 3 months.


It's not that easy. You can avoid running, enemas , TENS for pelvic floor and avoid any C hard stools... But what else can you do. After 3-4 days of bad pain and fever type symptoms, where I barely did anything but lie in bed, some blood- goo still drained out by itself, accompanying reduced pain and swelling from the left of the anal canal


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## NoFuture (Nov 7, 2012)

moor_91, can I ask you why a doctor offered you the solesta procedure?

Some doctors who couldn't find a right diagnostic of my problem offered me this solesta. I didn`t do it.

I know I always say the same thing, but I don`t think your problem is on the anal sphincter muscles. The results of the manometry that you posted don't show IAS weakness. And it would be very difficult that you had a damage in your IAS.

The long term straining would make weakness of elevator ani muscles (much before as IAS weakness) with a fall down of the rectal mucosa. Repairing the mucosa and making exercises for elvator ani muscles would be the best option, I think. If that doesn't work, you are always in time of doing a solesta procedure..

Solesta is a continence meassure for those with IAS weakness, If you had IAS weakness, you wouldn`t have only a problem of leaky gas, rectal odor... you couldn't contain fecal materia and you would s h i t yourself many times.. And for sure If you had IAS weakness, you would have a problem in the rectal mucosa consequence of the IAS weakness.

And think the possible consequences of this solesta procedure if you do it many times.. What happen in the future when this agetn dissapears. The space left by this material will not cause more weakness?

Did you try rectal aplication of vitamin E and hippopresive abdominals without any succes?


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## jhonball (Oct 31, 2012)

@moor_91 how are you now? hope better


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