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Re: GENERAL: 24 years old w/rectocele and prolapse... best treatment?
From: Amy Rosenman, M.D. (anonymous@obgyn.net)
Sat, 24 Jan 2009 07:34:27 -0600 (CST)
At Sat, 24 Jan 2009, Amy Rosenman, M.D. wrote:
>
>Message posted on Amy Rosenman, M.D. behalf by: Hope Waltman, Women’s
>Health Forum Moderator
I just saw a 32 year old with similar issues today. A Urogyn is a
better choice than a colorectal surgeon. Look for nonsurgical options
such as a Colpexin or a pessary. It is best to put off corrective
surgery until you complete your family. Hope this helps.
>Prolapse can occur at any age, a urogynecologist is the best option for
>evaluation and treatment especially if you are interested in non
>surgical options, and you should be as you want to have children
>someday. If surgical repair is done before pregnancy, you will likely
>need a cesarean delivery for each pregnancy so as not to disrupt the
>repair work. Pessaries are a very good interim option and are used
>frequently in this situation of trying to put off surgery until after
>your family is complete. There is also another option, Colpexin, a
>biofeedback pessary like device that adds support while helping your
>pelvic floor muscles strengthen with Kegel exercises. Best of luck to
>you.
>
>Amy Rosenman, M.D.
>Assistant Clinical Professor GYN
>Geffen School of Medicine at UCLA
>Santa Monica, California
>
>http://www.obgyn.net/meet.asp?page=/all_advisors/A_Rosenman
>
>Note: Opinions expressed here are for educational purposes
> only and, as such, do not constitute a physician-patient
> relationship. This information is not intended to supplant
> the need for you to consult with your physician prior to
> choosing therapeutic options and/or interventions.
>
>At Tue, 20 Jan 2009, Psychosomatic wrote:
>>
>>I'm 24, nulliparous, and I have known for a while that I have a smallish
>>rectocele and mild uterine prolapse (diagnosed by a gynecologist a few
>>years ago). I know without a doubt that the rectocele is due to years
>>of irregular stools (IBS) and some time being obese, although I'm at a
>>good weight now (YAY!). My present problem is to the point that a
>>couple times a week I have to ...help... myself go to the bathroom (to
>>be explicit, I have to insert a finger or thumb and push on the back
>>wall of my vagina to have a bowel movement). While doing this, I have
>>recently noted that my cervix is nearly at my introitus (less than an
>>inch away from the opening). That seems a little low to me...
>>
>>I saw a gyn PA at my school's clinic, and it seemed like she didn't know
>>what to do with me, so she sent me to colorectal surgery. Is that
>>right? Is that where I should go? Because I'm in PA school and I would
>>like to have kids at some point, I'm not interested in surgery if there
>>is ANYTHING else we can do (like a pessary... do they even use those
>>any more?)
>>
>>If you were treating a patient that had this problem, where would you
>>refer her? Gynecology? Urogynecology? Colorectal surgery?
>>
>>*sigh* I'm frustrated and embarrassed. I shouldn't have to deal with
>>this at this stage in my life... and the responses I have received from
>>my providers only make me feel more awkward and stupid. I don't want a
>>runaround. I want to go to the right person FIRST. Please help. :(
>
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