|Wombatclay...you had a sphincter...right? What were your symptoms? Did you have issue going #2 and did you have to splint to make it all come out? Any trapping of stool for you? And what did you do about it? Another cut to fix it or did they do the dead correct the first time?
Yes, I had a sphincter.
Sorry... I just love the way that sounds! Ok, back to reality.
I had a 4th degree tear so the tear went right through the anal sphincter and out the other side. The OBs who attended my birth actually teach a class for midwives on how to repair serious tears so I'm pretty confident they did it "right". I have two "flaps" on either side of my scar (I'm told these will even out a bit over the years) so it almost looks like my labia extend all the way back, wrap around the anus, and end a half inch or so "above" the anal opening (so the anal sphincter was torn in two places).
I don't have a rectocele or any bowel problems (other than now-and-then gas incontinence, the odd looking flaps, and the now-and-then pain when a flap gets "torn" a bit by tissue paper) but my OBs were very serious about their healing/down time. I was on several different stool softeners and laxatives for about 2 months following the repair and under explicit orders to keep my poo soft to the point of liquid for at least the first 6 weeks while everything healed. I also used an epi bottle with herbal blend and witch hazel/tucks pads instead of TP for about 2 months as well to prevent any "rubbing" of the area and on Dr's orders "sunned" my bottom (sit in sitz bath, apply aloe gel to healing tissue, lay on bed with nekkid bottom in a sunbeam for 10-20 minutes a day). They told me over and over to avoid any straining while voiding. And I think that really helped since it gave the muscle and tissue time to heal a bit before being "put to the test" so to speak.
Back to the text books... the anal sphincter is one of those infamous "donut muscles". It's a ring of muscle than can pull itself tightly closed or open more or less on command. A tear can either rip into the ring on one side (making a donut with a bite out of it) or it can rip right through (break the donut in half). So imagine the anal sphincter muscle is the drawstring at the top of a pair of pants. The drawstring can be pulled tight or opened up, but it's always a "ring" around the top of the pants. Once it's torn, the best fix is to overlap the torn edges by a bit and sew them together. This means the drawstring is a little bit shorter than it was, but the torn bits are secured to each other with a bit of a seam. The ok but not perfect fix is to sew the ends of the torn section together end to end. This means the drawstring is the same size but the sutures are going to be under a lot more stress and the overall repair may not be as secure. (there are a lot of factors at play during a tear repair so it's not necessarily up to the surgeon which type of repair... overlap or end-to-end... will be possible). And just like a c/s, you can't say much about the underlying repair based on how the skin healed.
So.... your drawstring is repaired. One possible problem is that the drawstring may have gotten stitched or caught on the pants a bit. In that case there will be one little section that doesn't "draw tight" or which stays tight when the rest is relaxed. Or you might find that the drawstring doesn't hold as well as it did and the pants "pop open" suddenly or are always a bit loose. Or the drawstring is uneven and part of the pants slips through the opening and stays there.
Does any of that help you figure out where the problem might be? A surgical repair of the the muscle may not help if the problem is that the rectum was repaired "crooked" (leaving a flap of tissue unsupported by muscle so it falls over the opening) or if the problem is the intestines have fallen out of whack. But chiropractic care (to realign the pelvis) or maya massage (to help soft tissue move into a better place) may be an option to try before surgery. On the other hand, if it's a sphincter problem (too loose, too binding, too uneven) then a surgical correction might work. Just keep in mind that the ideal fix leaves the sphincter a little bit smaller than it was before sooooo.... eventually the surgical option isn't going to be an option if you want to keep things open!