4th degree tear questions - Mothering Forums

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#1 of 6 Old 02-16-2013, 08:17 PM - Thread Starter
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I'm 2 weeks PP and finally beginning to feel like myself again. I had my baby at home, and all went well basically. I had a tear which my midwife deemed a labia abrasion. But I was having some issues healing and went to an OB. The OB said I had a 4th degree tear. I can't even begin to understand why there is such a HUGE discrepancy between what these 2 experienced care providers observed, but this is what I've got to go on for now. OB said that the tear was not internal, and used the word "rare" but didn't exactly say what was rare about it. The OB said that I will probably need to see a colorectal surgeon for repairs to deal with stool incontinence. 


I have had only one incidence of incontinence about 5 days after baby came, but I do frequently feel like I've got to rush to the toilet, and have little control. Other than this, I have not had any other symptoms of a 4th degree tear. For example, at 2 weeks I don't have any pain. And when I say no pain, I mean no pain. I can sit up, walk fine, sit on the toilet with no problems, go up and down the stairs, bend over and pick things up, etc. 


Assuming that the OB is correct and I do have a 4th degree tear, I would like to hear from some others about healing from this. Specifically about whether you had, or even needed, surgery for stool incontinence. If so, how did work for you. If you chose not to have surgery, how are you dealing with it? Is it possible to recover from a 4th degree tear without having surgery.


I would appreciate hearing anyone's story. 

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#2 of 6 Old 02-18-2013, 02:35 PM
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Ugh I'm sorry. Tearing sucks. My second tear was described as a "3.5." This was explained to me as meaning that the tear extended into the rectal sphincter, but not all the way through. My healing from that tear was similar to what you described, and I have not had any incontinence. I found it helpful to be assessed by a pelvic floor physiotherapist, and by a proctologist. Sending you blessings for a quick and complete healing.
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#3 of 6 Old 02-18-2013, 02:40 PM
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I am sorry about this. OB are better in diagnosing tears because they see more patients  than MWs. Many MW are also not equipped to repair tears  test and might be reactant of diagnosing something they can't  fix

That said, it never hurts to get  a second opinion . Go see a colorectal surgeon ASAP before you have issues with scar tissue.

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#4 of 6 Old 02-18-2013, 02:53 PM
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I have not had a tear due to childbirth but I did have colorectal surgery for a tunneling fistula. It was interesting that I did not feel pain unless my fistula was closed and infected, if it was closed and infected it was terrible, but once pressure was released I was fine. Once I had the surgery, which did require going through the sphincter, I healed really well. You most definitely do not want a build up of scar tissue in that area or they may have to remove it and that will create a longer healing time due to tissue infill. See a specialist, find out why your tear is strange... I have the utmost respect for well trained midwives but somethings are far beyond their scope of practice.
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#5 of 6 Old 02-18-2013, 03:14 PM
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I had a fourth degree tear, and it required about a bazillion stitches.  I healed well enough, but I now have a rectocele.  I'm so sorry that it wasn't caught sooner!

DD 2/08
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#6 of 6 Old 02-25-2013, 05:13 PM - Thread Starter
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Thanks everyone. These have been really helpful responses. I have seen both my midwife and the OB again, and they both still stick by their original diagnoses. So at this point I don't really care what anyone wants to call it. If I have a 4th degree tear that healed in 2 weeks, and with no incontinence problems, that's fine with me. The OB seemed to agree that if I'm not having any problems with incontinence then surgery might not be called for. However, she referred me to a colorectal surgeon and said that they would be better to consult with about long term implications for passing on surgery. I am interested in other opinions from other types of doctors, but I'm not really sure how to ask for those referrals since I basically don't know what I'm talking about. hmm... a few people mentioned scar tissue problems. is it that scar tissue builds up if you don't have surgery? Loonaj: what does a pelvic floor physiotherapist do exactly? surgery really scares me, and i would like to avoid it as long as possible. i guess i really need to know how effective the surgery usually is. thanks again everyone.
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