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What Does Frequent Urination Urge After Hysterectomy And Anterior Repair Indicate?
Question: I had a hysterectomy and anterior repair 6 months ago. Since the surgery I have had the feeling that I need to pass more urine after urinating. I have seen my consultant 6 times since the surgery and he said all was well.
On my last visit, instigated by myself, he did admit to the fact that the surgery "could have been better" and there was a moderate rectocele. I was noted to have a small rectocele pre operatively but he did not feel needed intervention. He has now referred me to another consultant and in this letter it says the cystocele is still present although smaller and the rectocele is large.
I feel let down as I feel he has not been honest with me.
Could the cystocele have got worse over the last 6 months, so at the time of the surgery successful?
If I had a rectocele at the time of the surgery should that have not been operated on?
Could the rectocele have got worse over 2 weeks? The reason I ask this as in that period it went from " bowel slightly prolapsed" to a " large rectocele".
I feel he has not given me the information I was entitled to.
There was talk of "tapes" for future surgery? How is this done and how long is the recovery period?
Is it advisable for me to be careful re exercise as this is my hobby?
Thanks.
On my last visit, instigated by myself, he did admit to the fact that the surgery "could have been better" and there was a moderate rectocele. I was noted to have a small rectocele pre operatively but he did not feel needed intervention. He has now referred me to another consultant and in this letter it says the cystocele is still present although smaller and the rectocele is large.
I feel let down as I feel he has not been honest with me.
Could the cystocele have got worse over the last 6 months, so at the time of the surgery successful?
If I had a rectocele at the time of the surgery should that have not been operated on?
Could the rectocele have got worse over 2 weeks? The reason I ask this as in that period it went from " bowel slightly prolapsed" to a " large rectocele".
I feel he has not given me the information I was entitled to.
There was talk of "tapes" for future surgery? How is this done and how long is the recovery period?
Is it advisable for me to be careful re exercise as this is my hobby?
Thanks.
Brief Answer:
As below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us with your health concern.
To answer your questions one by one, without making any assumptions on whether the surgeon was fully honest or not ( just going by the scientific facts ) -
1. You have not mentioned about the cystocele pre operatively - what was its pre operative status ?
2. If a small rectocele is present, it is often not corrected or at best a single stitch is put in. At times in some patients, correction of the uterine prolapse paradoxically worsens the rectocele, this is a known sequelae, and there is precious much that can predict in which patient group this is likely to happen.
3. 2 weeks for a rectocele to go from Slight prolapse to a huge rectocele is rare, unless there were strong precipitating factors - lifting weights, habitual constipation , a chronic cough etc.
4. For your urinary incontinence, the treatment is urethral tapes. These are small sling like structures applied around the bladder neck to fortify and tighten it, and improve the urinary symptoms.
Recovery from a tape procedure would take atleast 6 weeks.
Yes, be cautious regarding exercise that involves weight lifting and strian on the abdominal muscles, as it can trigger off / worsen a prolapse.
HOpe this information helped you.
Take care.
As below.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to us with your health concern.
To answer your questions one by one, without making any assumptions on whether the surgeon was fully honest or not ( just going by the scientific facts ) -
1. You have not mentioned about the cystocele pre operatively - what was its pre operative status ?
2. If a small rectocele is present, it is often not corrected or at best a single stitch is put in. At times in some patients, correction of the uterine prolapse paradoxically worsens the rectocele, this is a known sequelae, and there is precious much that can predict in which patient group this is likely to happen.
3. 2 weeks for a rectocele to go from Slight prolapse to a huge rectocele is rare, unless there were strong precipitating factors - lifting weights, habitual constipation , a chronic cough etc.
4. For your urinary incontinence, the treatment is urethral tapes. These are small sling like structures applied around the bladder neck to fortify and tighten it, and improve the urinary symptoms.
Recovery from a tape procedure would take atleast 6 weeks.
Yes, be cautious regarding exercise that involves weight lifting and strian on the abdominal muscles, as it can trigger off / worsen a prolapse.
HOpe this information helped you.
Take care.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yes thanks.
Pre operatively it was a large cystocele and the uterus was descented, 2 was mentioned therefore he did the hysterectomy and removed the ovaries.
I did do a little more in the gym as I was told it was fine to exercise but I have not got a cough and am not constipated. I'm slim and in normally good health.
So the tapes would be for the cystocele? Would they correct the rectocele which now seems to be the main problem. I have no trouble with my bowels except I seem to go more often but vaginally I feel uncomfortable.
I have not got urinary incontinence ( I did before the surgery), urinary wise just the feeling I have not emptied my bladder after I void.
What is the procedure for the correction of the rectocele? If I left it I feel it is going to get worse and cause me problems defaecating. Is that right?
So exercise wise, what can I do. I do a lot of pilates and Aqua exercises that would be ok? I also like to do walks and run for short distances, should I do that?
I feel very depressed now as I thought this surgery would be successful as I was told and I would be able to enjoy the summer, travel, look after the grandchildren etc.
thanks.
Pre operatively it was a large cystocele and the uterus was descented, 2 was mentioned therefore he did the hysterectomy and removed the ovaries.
I did do a little more in the gym as I was told it was fine to exercise but I have not got a cough and am not constipated. I'm slim and in normally good health.
So the tapes would be for the cystocele? Would they correct the rectocele which now seems to be the main problem. I have no trouble with my bowels except I seem to go more often but vaginally I feel uncomfortable.
I have not got urinary incontinence ( I did before the surgery), urinary wise just the feeling I have not emptied my bladder after I void.
What is the procedure for the correction of the rectocele? If I left it I feel it is going to get worse and cause me problems defaecating. Is that right?
So exercise wise, what can I do. I do a lot of pilates and Aqua exercises that would be ok? I also like to do walks and run for short distances, should I do that?
I feel very depressed now as I thought this surgery would be successful as I was told and I would be able to enjoy the summer, travel, look after the grandchildren etc.
thanks.
Brief Answer:
As below
Detailed Answer:
Hey relax.
You seem to be a wonderful, intelligent , active and fit person.
It is your mind that will ultimately help you come on top of all these snags.
I understand it is very annoying and frustrating to have repeat surgeries.
The tape would be for the cystocele and urinary frequency which you are having.
They would not correct the rectocele.
At the same sitting , it is advisable to have a rectocele repair as well.
Surgery for the rectocele is simply called posterior perineal repair.
It involves tightening the area, tucking in the bulge of the rectocele and stitching it up.
Of course, if not treated, it will get worse and leave you with problems for defecation.
But now you must ensure that only the most expert surgeon attempts the next surgery.
The ideal next step surgically is cysto - recto - cele repair in the most experienced hands.
Make sure it is a surgeon with high success rates and minimal failures.
Exercise wise, you can do cardio, but in moderation.
Any exercise would ultimately put strain on your abdomen, so it is best to do everything that you are doing, and plan to do, but in moderation.
Being depressed will worsen your state of mind and body.
Try and indulge in moderate exercise, pursue all the hobbies you want, get the repeat surgery done at the earliest so that you have the most of summer still to yourself.
Trust me, it is annoying and irritating, but both the cystocele and rectocele are easily corrected.
Take care !
As below
Detailed Answer:
Hey relax.
You seem to be a wonderful, intelligent , active and fit person.
It is your mind that will ultimately help you come on top of all these snags.
I understand it is very annoying and frustrating to have repeat surgeries.
The tape would be for the cystocele and urinary frequency which you are having.
They would not correct the rectocele.
At the same sitting , it is advisable to have a rectocele repair as well.
Surgery for the rectocele is simply called posterior perineal repair.
It involves tightening the area, tucking in the bulge of the rectocele and stitching it up.
Of course, if not treated, it will get worse and leave you with problems for defecation.
But now you must ensure that only the most expert surgeon attempts the next surgery.
The ideal next step surgically is cysto - recto - cele repair in the most experienced hands.
Make sure it is a surgeon with high success rates and minimal failures.
Exercise wise, you can do cardio, but in moderation.
Any exercise would ultimately put strain on your abdomen, so it is best to do everything that you are doing, and plan to do, but in moderation.
Being depressed will worsen your state of mind and body.
Try and indulge in moderate exercise, pursue all the hobbies you want, get the repeat surgery done at the earliest so that you have the most of summer still to yourself.
Trust me, it is annoying and irritating, but both the cystocele and rectocele are easily corrected.
Take care !
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks so much for your words of wisdom. I think I will be better when I see the other surgeon on Tuesday, but how good he is I don't know. At least it will it will be a step forward.
I think I should ask my GP to refer me to a speciality unit as I want the best possible outcome.
In the last week it has been difficult as I say, but at least as you say it can be put right and I have no disease.
Thanks again.
I think I should ask my GP to refer me to a speciality unit as I want the best possible outcome.
In the last week it has been difficult as I say, but at least as you say it can be put right and I have no disease.
Thanks again.
Brief Answer:
As below.
Detailed Answer:
Yes, it is much better to ask to be referred to the best possible person.
There are failure and complication rates, nobody can guarantee a 100 %, but atleast a renowned expert lowers your odds of having an unsavoury experience again.
Whether it is an act of omission / incompetence on the part of the earlier surgeon, or it is a new occurrence - that is now immaterial, as what matters is having the best possible person to put it all right.
It would be difficult, no doubt, but yes, it is not a chronic disease, and it is entirely treatable surgically.
Do not want to sound like a preacher, but think of those living with intractable cancers, they do not have the hope to be fit and fine and whole once again .
Counting your blessings will help you to stay positive while you await and prepare for the next ( and conclusive ) surgery.
Prayers for you.
You can approach me directly anytime by clicking on the link below -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
That way the answer does not go the general pool, where any doctor can pick it up, but is directed specifically to me.
Take care.
Wish you good health always !
It is the biggest blessing, after children ( and grandchildren, in your case ! )
As below.
Detailed Answer:
Yes, it is much better to ask to be referred to the best possible person.
There are failure and complication rates, nobody can guarantee a 100 %, but atleast a renowned expert lowers your odds of having an unsavoury experience again.
Whether it is an act of omission / incompetence on the part of the earlier surgeon, or it is a new occurrence - that is now immaterial, as what matters is having the best possible person to put it all right.
It would be difficult, no doubt, but yes, it is not a chronic disease, and it is entirely treatable surgically.
Do not want to sound like a preacher, but think of those living with intractable cancers, they do not have the hope to be fit and fine and whole once again .
Counting your blessings will help you to stay positive while you await and prepare for the next ( and conclusive ) surgery.
Prayers for you.
You can approach me directly anytime by clicking on the link below -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
That way the answer does not go the general pool, where any doctor can pick it up, but is directed specifically to me.
Take care.
Wish you good health always !
It is the biggest blessing, after children ( and grandchildren, in your case ! )
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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