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episiotomy complicactions

From: Melissa (anonymous@obgyn.net)
Wed, 1 May 2002 15:07:11 -0700 (PDT)


Dear Doctors, I hope you can help me. I am 28 1/2 and have a 7 month old daughter. She was delivered vaginally after a midline episiotomy. As I was healing from the laceration, I would feel a tugging sensation inside my vagina, on the left side. Later during my 6 week check-up I nearly fell off the table (from the pain) when the Nurse Practitioner examined me manually. She was trying to feel my left ovary at the time of the most excruiciating pain. She scheduled me for a vaginal ultrasound that afternoon fearing a hematoma. No hematoma was found and no pain was sensed during that exam...the doctors were being very ginger with me. I have had extreme pain upon entry during intercourse and a dull sort of pain throughout the duration of intercourse. I scheduled a second appt and this time I was sent to the head of the department for an exam. He told me I had adhesions and would probably have to live with it, or at least until I had another baby (in which case a subsequent episiotomy might help reverse the problem). I sometimes feel a tugging sensation and a internal heaviness or puffiness on the left side (where the pain is). Could there be some kind of pocket there or herniated tissue or loose pelvic floor muscles? In addition, (and possibly related) I have had painful bowel movements since about a month postpartum (I had them prior to pregnancy, but not during). I have had two manual anal exams (found a fissure) and two years ago I had an anascope, which also found a fissure. The pain is most often associated with more solid stools, but is there even when they are loose or thin. I have a very healthy diet of fruit, whole grains and drinks (no caffiene whatsoever). I attempt to go immediately upon feeling the urge. I have also noticed a heavy vaginal discharge when I have a BM. I have seen a nutritionist about my diet since this began. Recently, I noticed a skin tag on the left side of my rectum (where I am feeling the pain upon defacation) and a mole just outside the rectum. Could the painful BM be related to the skin tag, the adhesions (or whatever is really wrong with me vaginally) or something else altogether? The main problems are that with my discomfort we cannot resume a normal marital sex-life. It is really damaging my marriage and the painful bowel movements have made me dread restroom trips and so at times I nearly cut out eating solids so that I won't have to defacate. I would appreciate any information or advice you can offer.

Melissa

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