And the answer is ... rectocele and cystocele!

How about making an appointment with your gynecologist?

I have both rectocele and cystocele, most likely due to my 2 pregnancies and deliveries 35+ years ago. They were diagnosed during a routine pelvic exam. Mine must not be too bad since I have not needed any specific treatment. But, typically, a vaginal pessary is first line treatment for these sorts of prolapse. I was told to inquire if it became an issue. For difficult cases, surgical repair is often offered.

https://my.clevelandclinic.org...ases/17415-rectocele

Jan

Hi Jan,

Thank you for your quick reply and helpful suggestion. I am sorry to learn you have both a rectocele and a cystocele, but it is reassuring to learn they are not causing problems for you at the present time.

Thank goodness for the jpouch forum. I thank you most especially for moderating and for your generosity in sharing your wisdom and experience.

Much appreciated,

Jane

I would start with the gynecologist. Probably easier to get an appointment than the urologist. Waiting 6 months just for a consult seems ridiculous to me.

I am fairly certain that your total hysterectomy is a major contributing factor in your issues.

Jan

@SeattleJane posted:

Hi Jan,

Thank you for your quick reply and helpful suggestion. I am sorry to learn you have both a rectocele and a cystocele, but it is reassuring to learn they are not causing problems for you at the present time. I am not currently having any issues due to the cystocele, but the rectocele problems are pretty awful.

I have not had a gynecologist since 2007, the year I acquired a jpouch. My uterus and ovaries removed in the same surgery as my large intestine, so I no longer needed a gynecologist. The jpouch was another surgery 5 weeks later and I've had one rebuild 10 years ago.

I really appreciate your suggestion and will ask my primary care doctor for a referral to a gynecologist. Today I read about vaginal pessaries, but had no idea if a urologist or a gynecologist or ? would be the right specialist. Good to know.

Thank goodness for the jpouch forum. I thank you most especially for moderating and for your generosity in sharing your wisdom and experience.

Much appreciated,

Jane

You have not had a gynecologist since 2007? I do not think that is normal at all regardless if you had your system removed or not. I think you should still get checked at least every year. I am glad you are going to make an appointment to get a gynecologist.

Here is a source: https://www.kelsey-seybold.com...-are-still-necessary

Best of luck

@Mary2017 I really appreciate your concern and read the helpful link you sent (the Kelsey-Seybold site), thank you. Thanks again for your concern, I appreciate your taking the time to look out for me.

@jandollar Just to follow up, and to send extra thanks to your advice. I am now in the queue for an appointment with a uro-gynecologist. Cheers to you and thanks again for steering me to the right doc needed to address the issue.

Jane

@SeattleJane posted:

@Mary2017 I really appreciate your concern and read the helpful link you sent (the Kelsey-Seybold site), thank you.  As mentioned on that site, Pap smears are no longer needed for patients with a history of normal Pap smears and who no longer have a cervix (it came out with the uterus, ovaries and large intestine). My primary care doc does the annual breast exams, regular osteoporosis screening and I have mammograms every year. I did see the gynecologist/surgeon the first year after the hysterectomy and she said that going forward, it was fine to see my primary care doc for those matters. Even so, I would have continued to see her every year just because I liked her and it was fun to see her, but she retired! Thanks again for your concern, I appreciate your taking the time to look out for me.

Your welcome. I would have thought you would need to get the vaginal canal checked.

I have both for 20 years. It is a closure or partial closure if the rectum making it difficult to pass. My opening is very tiny and I also ended up with prolapse but for mine to be fixed due to my anatomy would be too risky so I live with it rather than going back to the outside bag.
read my post in general discussion how I manage (the best way I can). You may have better luck with ability to have fixed as we are all different. But there is a balance between fiber, types of fiber (psyllium) and liquids to help pass along with the warm water enemas.
read my post as it’s lengthy and I don’t want to re-write. It starts out “20  years experience…and is posted by me FRH

cystocele is a little different than rectocele. My rectocele is more the issue for me.

Jane, I am glad you are finally getting some pieces to your puzzle. Sure, it is not a cure, but some insight goes a long way to reducing frustration. At least it is nice to know you are not crazy. Hope your holidays are pleasant and full of hope!

Jan

I’m a bit confused. I had a rectocele but it went away when I had my rectum removed and pouch created. Jane and Jan, do you mean you have an out-pouching or weakness in your J pouch wall that protrudes vaginally? I also have a cyctocele and tried a pessary but it was not compatible with the pouch—the pessary compressed the pouch even further which would have made it impossible to empty.

Jane, you will usually need a urogynecologist for cystocele management, not a general gyn.

@Mary20177 there are few reasons why one would still need gyn after a total hysterectomy and salpingo-oopherectomy as there is no cervix left for a pap, no abnormal uterine bleeding, no tubes and ovaries to palpate. Essentially, there is no longer a need for routine screening. You may need gyn for a specific issue like a rash, vaginal dryness or other specific complaint but not for a routine exam.

@Pouch2021 posted:

I’m a bit confused. I had a rectocele but it went away when I had my rectum removed and pouch created. Jane and Jan, do you mean you have an out-pouching or weakness in your J pouch wall that protrudes vaginally? I also have a cyctocele and tried a pessary but it was not compatible with the pouch—the pessary compressed the pouch even further which would have made it impossible to empty.

Jane, you will usually need a urogynecologist for cystocele management, not a general gyn.

@Mary20177 there are few reasons why one would still need gyn after a total hysterectomy and salpingo-oopherectomy as there is no cervix left for a pap, no abnormal uterine bleeding, no tubes and ovaries to palpate. Essentially, there is no longer a need for routine screening. You may need gyn for a specific issue like a rash, vaginal dryness or other specific complaint but not for a routine exam.

I learned something new. I would have thought the vaginal canal would need to get checked for HPV or STDs