They Cut Into Your What?!?!

      Last Thursday I had a fairly major set of surgical procedures done at the Texas Tech University Medical Center.  These procedures have lovely long names that make them much easier to deal with than the actual description of what the problem was too.  The procedures were called:  Posterior Colporrhaphy , Trans-Vaginal Tape, and Perineoplasty.  As you can tell, these were all correcting problems with my girly bits.

     I am typically VERY embarrassed to talk about this kind of stuff with anyone, let alone describing it on the internet.  The thing is, all three of the issues I had corrected were incredibly common problems; just not for women my age.  I am 31.  Along with being somewhat uncommon for women as young as I am, they are problems that no one addresses because they are embarrassing. 

     No 27 year old wants to tell her OBGYN that she can't laugh without urine leakage.  It's humiliating.  But wait, it's not.  Especially if that woman has had children or some sort of trauma to her pelvic area.  OBGYNs and Urologists fix this problem every single day.  There is a fix and you don't have to live with the potential embarrassment of wetting yourself if you want to jump on a trampoline or thrash about in a mosh pit.  

     I was 21 when I had my daughter.  While I was pregnant I suffered through horrific morning sickness (24 hours a day for 3 months) and the problems I just had corrected (10 years later) began.  Every time I had to run to the toilet and vomit I also wet myself.  The force of the heaving loosened the muscles required to hold my urethra steady.  Having her proved even more traumatic.  

     Prior to giving a mother in labor an epidural (the spinal medication that makes delivery much less painful,) the care-givers are supposed to allow her to utilize a rest room or catheterize her so that the baby isn't being forced past a full bladder.  With me, they forgot that step.  So I pushed for two hours against a very full bladder before my daughter was born.  During the delivery, my perineum was allowed to tear, rather than getting an episiotomy.  This is common when the doctor decides that the tearing will be less damaging than actually cutting through tissue to make room for the baby.  These two things are the causes of problems that women don't talk about, but should.   

     I am actually really embarrassed to be writing about them, but I suffered in silence for 10 years before finally going to someone and saying something.  It shouldn't be that way.  There shouldn't be such a huge stigma associated with issues in the reproductive organs.  How else are we supposed to be health conscious people if we can't even tell our OBGYNs about these problems?

    I was experiencing two major issues with my body.  Turns out, these are VERY common issues, but I was mortified to have those issues so I didn't talk about them.  You have to understand, I don't fart in the same room as another person, let alone discuss my periods, urinary tract issues, and most especially rectal concerns.  This is not something I do.  I have on occasion started crying out of humiliation when I have passed gas unexpectedly where others could hear.  These are not things I talk about...ever!

     When I finally decided enough was enough, I went to the doctor.  I told her that I leaked urine when I laughed, coughed, danced, hit a bump in the road, or thought about doing any of those things.  I also told her about the other problem...the really embarrassing problems, the problems I didn't even  want to talk to my mom about....poop problems.

     See, the problems I was having were caused by tears in the muscles of my vaginal walls.  These tears were caused by the pressure of having kiddos.  This doesn't happen to everyone, but it is VERY common to have it happen due specifically to childbirth.  The walls weren't torn through, just the muscles  so I had what amounted to a recto-vaginal hernia and a minor uro-vaginal hernia.  The first called a rectocele the latter a cystocele.  The rectocele causes the rectum to swell into the vaginal area which when trying to have a bowel movement, can cause problems. It gives the BM two potential routes to take rather than the one.   The rectum bows out into the vaginal area and dead ends, often making it necessary for the woman to insert her fingers into her vagina and apply rear pressure  to the herniated area to actually have a successful bowel movement.  Can we talk about inconvenient and embarrassing, and without a name, just describing the problem is a devastatingly horrific affair.  This is why most women don't talk about it, even with their doctors.  The cystocele (in my situation) was incredibly minor and the operation to fix the other problems I was having will probably fix it, so they opted not to do corrective surgery on it. 

     The leakage of urine was caused by what they call hyper-mobility of the urethra.  Which basically means that my urethra moved around too much because the musculature had been fairly damaged and so it was actually the easiest and most common of my problems to repair.  It was done by making two small incisions above my pubic bone and sewing a small strip of mesh down and around my urethra in a sort of hammock in order to provide the support necessary for my body to not leak.  THIS IS SO INCREDIBLY NORMAL.  The OBGYNs didn't even blink  when I mentioned it (with my face turned down in a low low whisper.)  

     The rectocele repair is also an incredibly normal procedure.  They simply find the weak point in the recto-vaginal wall, make an incision, pull the muscles back together (given they are flexible enough,) and stitch them into place. Then, they stitch the wall back together.  If the musculature is out of place too long, it can lose its elasticity and then they simply sew a mesh to the muscles and then stitch you back up and then the mesh heals into the muscles and reinforces the weak spot.  Thus, correcting the hernia.

     With me, the problems were all caused by having my daughter, but in a round about way.  Remember I mentioned them allowing me to tear rather than cutting me?  Well I had her and the doctor stitched up the tear (ten stitches,) and then sent me on my way.  My stitches didn't take/weren't done correctly/fell out...you name it.  I had no perineum.  Not good.  Where there was supposed to be a good two inches of muscle, fat, and tissue to reinforce my rectum, bladder, and vaginal muscles, I had less than a quarter of an inch.  So my gynecological surgeon (a saint and a prince) did a procedure called a perineoplasty.  He cut away all the scar tissue where I had torn and healed incorrectly and rebuilt my perineum.    This one procedure will prevent me from having to deal with these issues again (barring immaculate conception at which time I will be scheduling a c-section.)

     I have read that 11-19% of women will undergo one of these procedures.  If you consider that in a  critical light, that's the women who talk about it or who have the resources available to address it.  In actuality, the number of women who need the procedure or are symptomatic of the issues is probably much higher.  73% of women will have children.  These problems are primarily caused by trauma to the vaginal walls during child birth.  PLEASE PLEASE, if you are having these problems, you are not alone and there are ways to fix it.  If they are minor, there are even non-surgical options.

     I am only 9 days out from surgery and I am still in considerable pain.  There were a few trip ups, including being released too early and ending up in the ER because the swelling in my vagina had made it impossible for me to urinate so I had to wear a catheter for five days.  Then I landed back in because I couldn't have a bowel movement and they admitted me overnight and I had to have a soap enema (embarrassing, yes, but there comes a point where the pain releases you from all concern of embarrassment).  

     Truly, I am shocked that I am writing this (because I am the girl who doesn't fart in the same room as others), but I had no idea how common my problems were and I allowed mine to cause me angst for 10 years.  Though I will say, I mentioned the leakage to my doctor in 2002 when I had pneumonia and was coughing constantly and of course leaking constantly and he informed me that "women who are 21 don't have those problems."  (My response, "well obviously they do...)  These are normal problems for women.  Women who have had children and women who have had any sort of abdominal trauma.  

     As I was getting wheeled into the OR, the nurse told me that I would never regret having these things fixed.  She said that she had had hers done 3 years prior and now she could run around with her kids and jump on a trampoline without concern.  Another nurse informed me that she had had hers done 10 years prior and hadn't had a single issue since.  Still another nurse told me that I should come back and let her know how mine went because hers was scheduled the following month.  This proved to me, even more, that I wasn't alone and neither are you if you are experiencing these issues.  Someone needs to talk about it.  Someone needs to say something so that the ice is broken and it paves the road for others to say something too.  Be brave.