How soon to have surgery?
Tl;dr: Repairing perineal muscle immediately but postponing other repairs while still postpartum. Has anyone done this?
Obviously I'm in contact with my urogyn about this, but I'm wondering if anyone has direct experience.
I am 5 months pp and also 24 months pp, and I have been pregnant and/or breastfeeding for almost 3 years. I have a stage 2 rectocele that is highly symptomatic. I use a ring pessary and estrogen cream, do PFPT, and am following an online prolapse exercise program that includes hypopressives.
I also know because of 3D ultrasound that my transverse perineal muscle is completely severed. I have a dull ache running in the background most of the time, sex is off the table, and I essentially have no perineum.
I don't know how much the rectocele will heal with time; not completely, of course, but potentially to the point of becoming asymptomatic. I don't think it's wise to address it surgically now.
However I do know that I will need a perineoplasty (perineorraphy). I'm toying with the idea of addressing that sooner rather than later, yes while breastfeeding, yes while having little kids still, and yes while unsure about future children, yes carrying the possibility I will still need a posterior repair in the future--in part because it may do a lot to help the rectocele, in part to regain my sex life and self esteem. Has anyone done the same or have thoughts on the matter?