Dear Motherload,
I struggled with constipation for several years, which led to a rectal prolapse,which led to damage to the nerve endings of my anus and/or sphincter. Now my anus doesn't have the strength it had before; it lost sensation in the nerve endings and it doesn't close shut the way it used to. I'm very frustrated.
My question is: Is there any way to repair the nerve endings? Or is this something irreversible? I was advised to do Kegel exercises, but I'm confused whether they target the muscle OR the nerves? I will do the Kegel's for the muscle, but what about the nerves? Are my anal nerves lost for good? Is there any hope for them to be the way they used to be?
Thanks in advance
Caprese
Dear Caprice,
You have had quite an unfortunate chain of events. However, I think there is still hope for your dilemma. The following are a few possible treatments that you could undergo in order to regain use and control of your back door.
First, there is a procedure that may be able to repair your damaged anal nerves. It is called sacral nerve stimulation. The sacral nerves run from your spinal cord to muscles in your pelvis. These nerves regulate the sensation and strength of your rectal and anal sphincter muscles. Direct electrical stimulation of these nerves is a promising treatment option for fecal incontinence caused by nerve damage.
Sacral nerve stimulation is carried out in stages. First, four to six small needles are positioned in the muscles of your lower bowel, and these muscles are stimulated by an external pulse generator. The muscle response to the stimulation generally isn't uncomfortable. After a successful response, you may have a permanent pulse generator implanted in your abdomen.
Then, a wire from the small, battery-driven device is connected to the sacral nerves. Through the wire, the device generates electrical impulses that stimulate the nerves, helping you regain continence. (I wish I had a remote control unit that would shock my ex-husband's ass whenever I took a notion, but I am not sure how keen I would be to shocking my own.)
If that therapy does not work for you, there are several surgical options available as well. Like sphincteroplasty. This is surgery to repair a damaged or weakened anal sphincter. In this procedure, an injured area of muscle is identified and its edges are freed from the surrounding tissue. The muscle edges are then brought back and sewn together in an overlapping fashion. This strengthens the muscle, tightening the sphincter. Sounds simple enough.
Also, there's sphincter replacement. An artificial anal sphincter can be used to replace a damaged one. The device is essentially an inflatable cuff, which is implanted around your anal canal. When inflated, the device keeps your anal sphincter shut tight until you're ready to defecate. To go to the toilet, you use a small external pump to deflate the device and allow stool to be released. It then re-inflates itself about ten minutes later.
That, my dear is modern technology at its finest.
Finally, there's sphincter repair. During a surgical procedure called a gracilis muscle transplant, a muscle is taken from your inner thigh and wrapped around your sphincter. This restores muscle tone to your sphincter. Not so much for your thigh.
I hope that these treatment options show you that there is hope that you could once again have a normal anal sphincter, but at the very least I hope that you have learned from your bad habits in the past and try not to do any further damage.
Thanks for asking Motherload!
Motherload is a Certified Nurse Assistant as well as an IBS sufferer, which means she knows a lot about poop. Got a question for her? Ask it here.