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Rectocele, Painful, Areas Near Tailbone, Bovine Graft, Surgical Mesh

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Posted on Sun, 27 May 2012
Question: I have pain upon sitting and suspect that it is related to surgery that I had 1 1/2 years ago for a rectocele. The pain is there mostly when I sit, but also after I excercise, mostly I walk on a treadmill for about an hour, sometimes I get on an exercise bike. Are nerves in the area of the tailbone responsible do you think? When the surgery was done bovine graft was used. I chose that over mesh as I was fearful of surgical mesh protruding from tissue and becoming a problem.
doctor
Answered by Dr. Deepak Anvekar (50 minutes later)
Hello,

To answer your question effectively, i would like to know a few details.

1. Please describe the pain, the severity and the duration of the symptoms ?

2. Is there any swelling or mass protruding at the site of pain ? If so, is there any redness, itching, discharge or any other symptom associated ?

3. Do you have any problems related to urination or bowel movements ?

Use of bovine grafts, for repair of pelvic organ (rectal) prolapse is common in reconstructive pelvic surgery. The reported complications are mainly late onset inflammatory reaction following the surgery.

The other causes of pain in the site could be infection in the perineal tissues or due to prostatitis.

Nerves in the perineum are well protected, and are located on the interior aspect of the pelvic bones and not on the surface.

Hence the possibility of involvement of the nerves and resulting pain years after the surgery would be less likely. Such injuries present soon after surgery, and would include issues like incontinence of urine or stool.

I shall provide more specific answers to the cause of your symptoms, once you provide additional information as requested.

You might also ask additional questions if you have. I shall be happy to help you with them.

Regards.
Above answer was peer-reviewed by : Dr. Manju M
doctor
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Follow up: Dr. Deepak Anvekar (1 hour later)
Thank you. The pain is right at the tail bone /coccyx area? It has been a recent development. I notice it the most right after I ride my exercise bike. When I get up off of the seat I feel a definite uncomfortable pain, like I had just sat an a rock on my tailbone area. I haven't fallen on that area of my body. Also interesting to me is that I have noticed that since I have had children it is uncomfortable to sit on a bike seat?
doctor
Answered by Dr. Deepak Anvekar (49 minutes later)
Hello again,

Thanks for the additional information.

This information, is suggestive that you might be having coccydynia, which could have occurred due to a unobserved or accidental injury.

Coccydynia is due to Inflammation of the tailbone or coccyx, located between the buttocks. This is associated with pain and tenderness at the tip of the tailbone which is often worsened by sitting.

Pain caused by sitting on a soft, but not a hard surface. As I understand it, this is usually happens when the joint between the sacrum and coccyx is unstable, so that the coccyx can be pushed out of place when you put pressure on it by sitting or lying. When you sit on a hard surface, most of your weight is taken on your 'sit-bones' (ischial tuberosities), the hard bits at the bottom of your pelvis. But when you sit on a soft surface, the foam rubber pushes up between the bones, increasing the pressure inside you and pushing the coccyx out of place.

Steps to manage this condition include using a well-padded seat when sitting and avoid long periods of sitting when possible. Rest, avoiding re-injury to the affected area, antiinflammation and pain medications (Advil , motrin or diclofenac) can relieve symptoms.

In case the pain is very severe, and is persistent, you might consult your doctor who can treat it with local steroid injections, which are given on Outpatient basis. Such injections may help in complete resolution of the symptoms altogether.

In case, the symptoms do not subside, and is unrelenting, a surgical resection of the coccyx can be performed to remove the irritated bony prominence.

I hope the information provided here is helpful.

I shall be available to answer any follow up questions, or any doubts that you might be having.

Regards.


Above answer was peer-reviewed by : Dr. Manju M
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Answered by
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Dr. Deepak Anvekar

General & Family Physician

Practicing since :2003

Answered : 336 Questions

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Rectocele, Painful, Areas Near Tailbone, Bovine Graft, Surgical Mesh

Hello,

To answer your question effectively, i would like to know a few details.

1. Please describe the pain, the severity and the duration of the symptoms ?

2. Is there any swelling or mass protruding at the site of pain ? If so, is there any redness, itching, discharge or any other symptom associated ?

3. Do you have any problems related to urination or bowel movements ?

Use of bovine grafts, for repair of pelvic organ (rectal) prolapse is common in reconstructive pelvic surgery. The reported complications are mainly late onset inflammatory reaction following the surgery.

The other causes of pain in the site could be infection in the perineal tissues or due to prostatitis.

Nerves in the perineum are well protected, and are located on the interior aspect of the pelvic bones and not on the surface.

Hence the possibility of involvement of the nerves and resulting pain years after the surgery would be less likely. Such injuries present soon after surgery, and would include issues like incontinence of urine or stool.

I shall provide more specific answers to the cause of your symptoms, once you provide additional information as requested.

You might also ask additional questions if you have. I shall be happy to help you with them.

Regards.