rectovaginal fistula, rectocele, cytocele info on alternatives to surgery +

[mamaharrison]

I am looking for shared experiences on rectovaginal fistulas. I have a small one I have been living with since DDs birth in 2009. It seems to have become more noticeable to me since birthing my DS 11 weeks ago {uncomplicated, homebirth of BIG baby boy 11lbs--no tearing at all but very stretched out afterward}. I consulted a colorectal surgeon for dx. and a PT referral today and she was less than helpful with discussing options etc.--in fact she wanted to do exploratory procedure to measure the fistula and while I was out {without any discussion of best treatment options for me} fix it while she was there with a 'plug'. I expressed concerns {i will not do that} about the fact that I will be having more children 2 or 3 more and she didn't seem to think waiting would ever be a reasonable option because of the risk of UTI during pregnancy. She told me that could just schedule the cesareans so that the repair wasn't compromised--WTF?!! After I jst told her that I planned my homebirth with DS.

So, mamas--Rectovaginal fistulas. talk to me about your experiences. I need resources for different repair options with outcomes. Experiences with the wait until I have all the babies vs. the fix it now and hope it doesn't get screwed up in future birthing. Any other options? Consequences of waiting for repair? pros and cons.

Also, I know about the whole woman website--anyone use their 'system'? should I buy the book and yoga DVDs? Do they work? Gotta work on the prolapses, too--do not want surgery for those!

tia

[MountainMamaGC]

Most doctors will strongly recommend a c-section if you have a recto-vaginal fistula. I have crohn's disease and I have had fistulas in the past, that have healed while in remission. If I could get pregnant again I would not attempt a vaginal birth if I had a fistula. I would only consider vaginal birth if I didnt have one. You have a hole that is connecting your rectum to you vagina. Birth is not going to do anything good for that, and the complications are very difficult to fix. If that hole gets big enough you will be leaking stool and involuntary passing gas from your vagina. I have been on crohn's forums, and I have noticed that fistulas can be difficult to fix, even with surgery. The bigger the fistula the harder the fix, and setons can fall out.

I am pro home birth too, I think its great, but I do think there are some situations where a c-section is a wise decision. If it were me, I would have it fixed and then have c-sections for the rest of my births. A fistula is not something I would want to deal with long term. Not only can the symptoms be embarrassing, it can also wreak havoc on your love life. 

[fruitfulmomma]

I don't know much about this subject, but here is a hospital in Etheopia that specilizes in repairs. I wonder if you could contact them to see what their protocols are. It seems likely the women they work with would not have easy access to repeated c-sections if they go on to have more children. http://www.hamlinfistula.org/index.html