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7 replies

2nd degree vaginal tear help

S sally85Member
I guys, ive been posting the same sort of topic for a while now, ive been having so many appointments and so many specialists throwing so much info my way that this is the only place that feels safe to come to...the story so far is so...i was diagnosed with uc at 19, and my first child at 25 closely followed by an emergency operation to remove the whole large intestine because of a flare that didnt calm down. At the time of delivery i was told i had a 2nd degree tear and it was sutured up and left and no more was said about it.

I had my 2nd child at 27 (im now 28) and he was delivered by c-section on my consultants say so as to avoid any tearing to the back passage...after this and up until now i have had and still have the ileostomy. I wanted to have this reversed and saw a surgeon at st marks hospital in harrow, england, today, he told me that i have damage to the sphincter due to childbirth and the j pouch as the situation currently stands with the muscles would be a very bad idea due to the incontinence, he said the damage was due to the tear at childbirth...so basically i just had a few questions...

1. Has anyone had any similar experiences and what was the outcome?

2. Did anyone have a tear during childbirth but has gone on to have the j pouch created, if so, how is it now?

3. Is there anything i can do to help my situation? as i really dont want to keep the ileostomy permanently

4. Has anyone had surgery to fix the anal sphincter and then gone on to have the j pouch created? and how is it now?

5. And any info or help anyone can give me would be appreciated so very much, thank you x
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Jan DollarJan DollarModerator, RN, retired
Gee, I had a 4th degree laceration with my second birth (lacerated completely through the rectum). It was 8 years before my final flare, colectomy, and j-pouch surgery. My continence is fine (for now at least), nearly 19 years post op. I guess I am lucky. I do have pretty severe rectocele and cystocele (also from that delivery- nearly 10 pounds with a 15 inch head). Still, the only incontinence I have is if I have a bad cold with unpredictable cough or sneezing, but not full blown incontinence.

They say you get sphincter damage/weakness with every pregnancy and delivery, even c-sections, so the laceration may or may not be the major issue. But, if you have incontinence now, the j-pouch will make it worse. Also, if you have sphincter weakness, there is no surgery to repair it, short of an artificial sphincter implant. Others have tried injections of bulking material, with no so great results.

Jan Smiler
Jan DollarJan DollarModerator, RN, retired
Well, they say there is sphincter damage with every pregnancy brought to term, regardless of the type of delivery (obviously, vaginal delivery is more damaging, but the pregnancy itself puts strain on those structures).

In a general sense, any nerve trauma can take up to a year for the body to repair itself. After that, it is considered irreversible.

I have no idea what your specific damage state was before your last pregnancy or after it. I was speaking in general terms, not specifically to your case. But, generally, the longer it has been present, the more likely it is that it is irreversible. I am not trying to dash your hopes, but trying to help you gain perspective about what your options are. It is sort of like a form of paralysis, and once the function is lost, it cannot be regained.

They do have artificial sphincters, but they are not without their own set of problems.

Jan Smiler
skn69skn69Member
Sally,
Only two suggestions here...can they test the nerves to see exactly how damaged they are? There are very specific tests and they should be able to map the sphincter.
Next, as always, if you cannot have a jpouch and do not wish to keep the ileo then there is the possiblity in England (at St Marks as a matter of fact plus a couple other places) to have a k pouch done.
It is not an easy surgery, you need a really experienced surgeon to do it and you must have a good dialogue with him. The pre-op and post op relationship with him is primordial. But it is possible and can give you a very good quality of life.
Post on the kpouch part of this forum
sharon

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