Many of your docs sounded really pushy, thankfully all the specialists I seen were very professional.
My problems didn't start until 5 years after my 2nd tear free birth, surgeons explained that problems from 3rd and 4th tears can start years later as the muscles get weaker from subsequent births, nerve damage and age. I also read this in medical research as I have trust issues with doctors. (I always double check) I think that's what they're talking about when the docs say even if u don't tear the pressure weakens or injures internally, i
When they did ultrasounds in my sphincter defect
they said they were suprised I wasn't inconinent, but I have really strong squeezing muscles which compensate for half a sphincter, so its really extra important for us to keep up the KEGELS!