FISTULA SUPPORT ONLINE
Helping you to cope with the pain of fistulas

Surgery – The Different Procedures

There are a number of different procedures to combat fistulas. Depending on your particular case and how severe it is, your surgeon, and even the country you live in, will determine which procedure may be recommended to you.

Definitive treatment of a fistula aims to stop it recurring. Treatment depends on where the fistula lies, and which parts of the anal sphincter it crosses.

There are usually several stages to treating a fistula. You may start off with a seton, and then have another procedure such as Advancement Flap surgery.

What follows are brief descriptions of the different surgery procedures associated with fistulas. If you surgeon is recommending any of these procedures to you, make sure you are prepared, research and ask lots of questions!

 

Doing nothing – A drainage seton can be left in place long-term to prevent problems. This is the safest option although it does not definitively cure the fistula.

Fistulectomy – Excision (removal) of the fistula track, allowing it to heal by granulation, so the tissue fills the space as it grows.

Lay-open - This option involves an operation to cut the fistula open. Once the fistula has been laid open it will be packed on a daily basis for a short period of time to ensure that the wound heals from the inside out. This option leaves behind a scar, and depending on the position of the fistula in relation to the sphincter muscle, can cause problems with incontinence. This option is not suitable for fistulas that cross the entire anal sphincter.

Cutting seton – If the fistula is in a high position and it passes through a significant portion of the sphincter muscle, a cutting seton may be used. This involves inserting a thin tube through the fistula tract and tying the ends together outside of the body. The seton is tightened over time, gradually cutting through the sphincter muscle and healing as it goes. Once the fistula tract is in a low enough position it may be laid open to speed up the process, or the seton can remain in place until the fistula is completely cured and the seton eventually falls out.

Draining Seton – A length of suture material looped through the fistula which keeps it open and allows pus to drain out. In this situation, the seton is referred to as a draining seton. A stitch is placed close to the ano-rectal ring – which encourages healing and makes further surgery easy.

Fibrin glue injection - This is a method explored in recent years, with variable success. It involves injecting the fistula with a biodegradable glue which should, in theory, close the fistula from the inside out, and let it heal naturally. This method is perhaps best tried before all others since, if successful, it avoids the risk of incontinence, and creates minimal stress for the patient.

Fistula plug - This surgery involves plugging the fistula with a device made from small intestinal submucosa. The fistula plug is positioned from the inside of the anus with suture. According to some sources, the success rate with this method is as high as 80%. This treatment option does not carry any risk of bowel incontinence.

Advancement flap surgery - This is a procedure in which the internal opening of the fistula is identified and a flap of mucosal tissue is cut around the opening. The flap is lifted to expose the fistula, which is then cleaned and the internal opening is sewn shut. After cutting the end of the flap on which the internal opening was, the flap is pulled down over the sewn internal opening and sutured in place. The external opening is cleaned and sutured. Success rates are variable and high recurrence rates are directly related to previous attempts to correct the fistula.

LIFT Technique – This is a novel modified approach through the intersphincteric plane for the treatment of fistula-in-ano, known as LIFT (ligation of inter sphincteric fistula tract) procedure. LIFT procedure is based on secure closure of the internal opening and removal of infected cryptoglandular tissue through the intersphincteric approach. Essential steps of the procedure include, incision at the intersphincteric groove, identification of the intersphincteric tract, ligation of intersphincteric tract close to the internal opening and removal of intersphincteric tract, scraping out all granulation tissue in the rest of the fistulous tract, and suturing of the defect at the external sphincter muscle.

39 Responses to “Surgery – The Different Procedures”

  1. What are the different pain levels for each procedure ? I guess the ones that are cut open and need packing. I I had not read this or researched I would have no idea what option availablr to me. I’m having the dye interted and then they’ll decide whilst i’m under what to do. can i ask to be woken up and given the options to think about?

  2. I had the LIFT surgery on monday an have not experienced a lot of pain. I got morphine following the surgery, but the next days paracetamol and ibuprofen was enough. I am on day 4 after surgery and take paracetamol once or twice per day. The area is very tender but I am not having any pains as such.

    • Hi,
      how are you recovering from the LIFT procedure? Do you still have any pain, has the fistula tract completely been eliminated?

  3. hello,
    I have had Crohn’s Disease for 35 yrs.
    Had stoma for 4 yrs. now and surgery to remove colon, rectum, anus 2 yrs. ago. Throughout last 10 yrs. have suffered with fistualizing crohn’s, perianal abcess. With the complete removal of lower bowel I thought that fistual problem would be gone as diseased bowel gone….this week was told by specialist that I have peri-anal crohn’s disease and need a surgery called volvectomy. Any help would be supportive, thanxs.

    • My 31 yr old son is facing the same. First jpouch, then jpouch removal with ostomy placement, then anus/rectum removal due to multiple infections and surgeries. Had “ken butt” surgery February 2013 which wound has not healed, huge hole where his anal hole was; also recurring hospital visits for weeks at a time for fistulas popping up 4 places in butt now lower back. He had no active crohns. Doctors/surgeons dumb founded. What do I do?

      Mom S

  4. I had a Lift procedure done almost 2 wks ago & I am still having mucus drainage at the opening outside the rectum ring. I wonder if this normal. I see my doctor in 3 days but the office staff says that this is normal but I beg to differ.

  5. I had the LIFT procedure only a week ago and can echo that, given a post-op localized anesthetic injection that apparently lasted a couple days, and medications ( an anti inflammatory and an antibiotic) and a bit of ice pack after the first couple days there was not much pain at all. Discomfort, sure. I am wondering if it is normal to feel sapped of energy and strength for a long time.

    • Hi, it’s now been 2.5 weeks – still mucusing plenty. Saw the doctor and he said there had been a bit of skin tearing, and to stay barely active – no heavy lifting or walking for exercise or climbing ladders. I stay in bed a lot waiting to heal – not working now as my work is very physical. Still getting stings of pain from the wounded area – hope it’s getting better’ inside and out

      • Hi, it has now been over 3 months. The surgeon has okayed me for regular activity and last time I saw him, about a month ago, I was still having bleeding, mucus and pain issues. He examined me externally and said it looked ok and we’d play it by ear. I still bleed from my fistula opening and have some mucus from my anus sometimes so I still wear gauze. Not infrequently it flares up and becomes swollen, hot, and painful back there. Starting to wonder if it will ever really heal! I am going to log my symptoms for a few weeks and go back to the surgeon. It is tolerable to live with but not comfortable.

      • Hi holly! I’m so sorry you’re unwell. After hell and back for two years of perianal abcess open wounds, fistulas and rips… The most agony I’ve felt and heard that others have felt above giving birth! … Id like to tell you that it was diagnosed as open for the rest of My life… But through changing my diet it healed against all odds. Cut out meat and dairy. Drink a heck lead of organic herbal tea.. Make smoothies… And do one thing a day that makes you smile. For me it’s my dog. Be it a you know what for the men, be it simply baking cookies! …. Point is, is I got better…. Hope for all of us friends. Xxx

      • Hi, 6 months post-LIFT-surgery here. I haven’t seen the surgeon since the last time I wrote. I am getting active again – going back to the gym and all that. Possibly the mucus leakage has stopped. I usually don’t wear gauze except sometimes at the gym. The swelling is not so common anymore especially depending on how long and hard I sit on it. I could be living a normal life now except I’m taking the option of not returning to work at this time. Healing-wise, the outside of the fistula seems to be healing over even though the inside is not healed – it is still a closed tunnel. So when the outer opening heals over, the tunnel fills with blood and this eventually pops. This has been going on a while. I suppose I COULD live like that forever… I’m going to call my surgeon and see if he wants to take any action or continue to wait and see. Just updating to see if any other LIFTers have had similar experience, or to let them know what my healing has been like.

  6. Its very informative. But add information about Kshar sutra treatment . This is ancient Ayurvedic herbal treatment. In India people are preferring this technique instead of modern sugery.

    • Dear DR Prasad,
      I agree but cannot find info about treatment in Sydney Australia. Can you lead to somebody that can do this as my GP is not aware of it. Also if you can please issue some reference material on this treatment also.

  7. I have the option of having my fistula ‘layed open’. I’ve already had 4 bits if surgery (including lift procedure which unfortunately didn’t work) and this is a new tract that only goes through a small amount of muscle. I don ‘t know what to do as would rather wear a seton long term than be incontinent….previous surgery has not been painful at all but the lay open option sounds scary…. Please help if you can…!

    • I have been fecal incontinent ever since J-pouch surgery in 2008. It’s been really bad (lost my job, can’t really leave home) after getting Lyme disease in 2010. I also have a fistula that most likely formed because of the difficulty in keeping the perianal area clean. (I leak every 30 sec to every minute or so). All my CR has done has put in a draining seton and has prescribed antibiotics when things start flaring up again. It’s been nine months with this seton and I HATE it.
      However, as much as my fistula hurts and the seton is difficult to deal with I have to say that the incontinence is way worse. I am never clean, my skin down there is raw, I develop fungal infections from always being wet, it itches like mad, and all that irritated skin runs the risk of getting an infection from the feces touching it which would lead to more abcesses and fistulae.
      Now, keep in mind that since my colon has been removed that my stool is liquid. If you get the lay-open and become incontinent your stool would presumably be more solid and less frequent and perhaps easier to clean up and all.
      Think of all the consequences and consider all the procedures available. Ask lots of questions before you commit.
      -B

      • Just wanted to comment that this sounds very awkward and uncomfortable and I am sorry for it. I can only hope, in my relative ignorance of your circumstances, that things get better for you!

  8. Ok , Had LIFT procedure carried out in september. WAs very sore and uncomfortable for about 3 weeks. Most of this was due to the wound which was left open. Went back to work after 4 weeks and all seemed good. In fact , I hadn’t felt so well since all this started.

    Reviewed by the surgical team 6 weeks after surgery and they were hopeful it was going to heal ….. well , it was doing what it was supposed t be doing anyway!. Still felt great , right up til end of november when I got an infection which was cleared up with antibiotics.

    Not felt so great since , still have a small amount of occasional discharge and if I’m lucky a small bleed as well.

    Back to surgeons on Monday for a review to find out if it’s worked or not. Not sure either way how this is going to go. Whilst it’s nowhere near as bad as it was , it’s also not as good as it was before the last infection.

    I suppose this could go either way , trying to be hopeful but mindful not to get my hopes up too much.

    Will let you know the verdict on monday…..got everything crossed x

    • Update…… Alas , LIFT hasn’t fully worked. Seems the internal opening has closed but the tract and the external hole are still open. Booked in for Advancement Flap in April. I would be grateful if anyone has had this procedure carried out successfully could give me any tips on how to increase the chances of it working could let me know …..Ill try anything within reason!

      x

      • Sounds kinda like what happened to me, though I have been sorta abandoned to the healing process by my surgeon. It’s been 7 months since my surgery and still healing. Like you, I think the inside may have sealed but the tract and outer hole remained, but I think they are slowly healing. The outer hole has healed over a few times, and then burst when the tract filled too much with blood and fluid. To be honest, I think it might actually be getting better. Then again, I have thought that before… I figure as long as the internal abcess and infection that started the whole thing heals, I could conceivably live with an unhealed half-sealed fistula. I even have hopes of riding my bike again some day not too far off. Best of luck to you

      • Thanks for that Hallie , you’d think the internal hole would be more difficult to heal than the other . I’m in full agreement with you , as long as it drains and the dreaded abcess is kept at bay , that’s what really matters.

        I have already pretty much decided that if this surgery doesn’t work (will be my 5th in 22 months!) they can leave my bum alone. I may let them put a draining seton back in , but no more slicing and tying for me after this one .

        I’ll keep you posted
        S x

      • Hi guys , Went in for my advancement flap surgery last week and got lucky. Where the LIFT procedure had partially worked my surgeon has now been able to lay open the rest of the fistula tract . He did warn me that there was a 1 in 3 chance of slight wind and faecal incontinence afterwards but he was very optimistic he could get rid of the pesky fistula once and for all .

        God , does it hurt!!!! mind you I’m thanking my lucky stars as I’m told the advancement flap is much worse pain wise.

        Seems to be healing ok at the moment , loads of yukky discharge , hurts to sit on , hurts to walk about but I’m working on the no pain no gain theory .

        Whilst I’m feeling rather rough because I now have a large open wound up my bum , it is a different sort of rough feeling than the constant “I’m trying to fight off infections” that these fistulas leave you with fairly permanently , so I am hopeful .

        Keeping everything crossed (ok I can’t cross my legs of yet!) . Follow up middle of June when hopefully I shall finally be fistula free

        S x

  9. I had my surgury about 2 weeks ago the surgeon left catting setons. My question is if the feces should pas through the setons. I do not know if this is normal. When I have bowel movement, it is very painful and the pain continues like that for 3 to 4 hours. I change the gauze often but, I noted brown material like feces. How long am I going to have these symptoms? The catting setons is an effective alternative. Pleace give me some info.

    • Hi Rafel , I didn’t have a cutting seton but I did have a draining one. Without wanting to sound too graphic occasionally a poo would get caught up in the seton and i’d have to untangle it. This could be what is happening to you.
      I would suppose it is also possible that a bit of poo could enter the fistula tract from the internal opening , and therefore get caught up in the cutting seton and come out through the external hole of the fistula . I would get this checked with your dr as if this is happening a lot it will be a prime site for further infections which can lead to nasty abcess .

      Hope you’re feeling brighter soon. I had my seton in for 6 months and after a couple of months I was feeling quite a bit better , not great , but still better than I was before the seton.

      Hope that helps
      Sarah x

  10. Hi ive had cutting seton procedure. My first op was in November , then 23rd December and back to Doctor next week to book for next Op end of next week. It is a awful thing to go through, but ive tried to keep my life as normal as can be. Still going out in the evenings and socializing just be positive. Dont sit and be depressed, their are people who have it far worse. My top tip is keep clean do all all your salt baths and keep your head up. im not trying to play it down it is horrible but we can do it. Good Luck to all my fellow fistula sufferers. Thank you for the wonderful online support, whenever i panic or feel in doubt your just a click away.

    Thanks Major Bum Sore

  11. I had the LIFT procedure done at St. Michael’s in Toronto 3 weeks ago. There was a lot of pain for the first 5 days post op. After that I felt better and better. Still have a small amount of drainage but not a lot. Still doing sitz baths twice a day. My surgeon said it looked great 1.5 weeks post op. Honestly haven’t felt this well in 3 years since my diagnosis. I urge anyone who has been diagnosed with an anal fistula to get it fixed immediately and make sure you go to a colorectal surgeon who has experience in all the different procedures. I wasted a lot of time with antibiotics and dietary restrictions to no avail and seeing general surgeons who didn’t specialize in colorectal procedures.

    • Update. I’m on week 9 of my recovery from my LIFT surgery. Feeling great. Had two scares when the external opening became very swollen but the surgeon said it was because the cavity created by the abscess (fistula) was scarring over and healing inside. That was a month ago and it has subsided. Feeling good and happy that this ordeal seems to be behind me. Please don’t delay getting your fistula fixed. You will waste your life away with homeopathic remedies and non surgical options. All told, I missed 4 weeks of work with the seton and the surgery. I probably missed that same amount over the years in sick days and feeling lousy because of the fistula. Plus I put off vacations, relationships and general quality of life because of this affliction. My only regret is not having dealt with it sooner.

      • Hi J,
        I am on week 4 post LIFT procedure. This is my second LIFT surgery as the first one was unsuccessful. Can you please let me know how you felt 9 weeks post op in terms of symptoms (i.e. did you still experience any draining or mucus or blood? Can you still feel scar tissue where the external opening is)?
        Thanks!

      • Hi CDR,
        Oh no! Second LIFT…that’s no fun. I’ve heard that the majority of second LIFT procedures work well. Recovery was rough for me for the first 4 weeks but after that it healed really fast. I had no symptoms at 9 weeks but could still feel the scar tissue. I’m now 4 months post op and am feeling amazing. The scar tissue in the tract seems to have softened. There was no drainage from week 5 onwards. I did nothing except walk for three months but have been back at the gym, playing tennis, and riding my bike.
        My surgeon had done 20 LIFTs prior to mine and had a 90% success rate at the time of my surgery.
        Hope this helps. I’ll check back to see if you have any more questions.
        J.

      • Hi C,
        If you’re feeling nervous about the fistula returning, I suggest getting a properly trained colorectal surgeon to take a look at it. I don’t think I can reference names on here but there is a female colorectal surgeon who I saw at St. Michael’s. She is matter of fact/straight to the point. You can probably figure out who it is by googling St. Mike’s colorectal surgery department or ask your family doctor to look into it for you. It took me 3 months to get in to see her but my surgeries were both booked just two weeks in advance so once you’re in, you won’t have to wait if surgery is the option. I would go for coffee with you but am in Europe until the fall.
        What I’ve learned is that every fistula is unique and while commiserating is helpful, it is best to find a proper surgeon with a good track record who can take action and fix it!
        I am now on month 5 and so grateful for the new lease on life that I have.
        Don’t waste anymore time feeling uncomfortable.
        Best,
        J

    • I had the L.I.F.T procedure done by a female colorectal surgeon at St. Michael’s Hospital in Toronto exactly 13 days ago. I have a feeling it might be the same surgeon who treated you. I had my fistula for exactly 2 years, 3 months and 1 day before I finally had the procedure. Prior to having the fistula I had a large internal sinus caused from a reoccurring anal abscess that I acquired from an infected anal gland resulting from an internal lateral sphincterotomy I had previously to correct a reoccurring anal fissure. The general surgeon who originally did the lateral internal sphincterotomy on me actually did not follow the correct procedure in carrying out the surgery and it could be the whole reason why I ended up with the infected anal gland. I was told by one of Canada’s top colorectal surgeons that she made the incision in the wrong spot so what I consented to on the forms I signed was not the actual surgery I received. The sinus only became a fistula when the abscess came back and I went into the ER because of how much pain I was in and the emergency room doctor didn’t listen to me when I told her if she cut me open from the outside on my but cheek it would be creating a fistula because I had always had my absences drained from the inside. She cut me open anyways, insisting it needed to be done thus creating the fistula. It was at this point that I realized I was going to need a specialist and was referred to St. Michael’s Hospital in Toronto. I had the large sinus inside my anal cavity with a reoccurring abscess that had been drained surgically multiple times for about 11 months before it was turned into a fistula. I had a draining seton put into my fistula tract about 13 months after the fistula was created and diagnosed. The seton remained in my fistula tract for 14 months before I finally had the L.I.F.T procedure done. If you do the math correctly that means I’ve been dealing with anal/rectal problems for about 3 years, 4 months and approximately 3 weeks now. I had two colonoscopies done while the seton was in and one sigmoidoscopy done when it was just a large sinus in my anal canal. I’ve had multiple abscesses drained, several observations under anesthetic, and countless minor procedures done to better observe my fistula. My surgeon at St. Michaels told me I wasn’t a good candidate for the fistulotomy as the tract of my fistula runs too much through my sphincter muscle and incontinence would be a concern. For me, personally the surgery was very painful. Words really cannot describe the unimaginable amount of pain I was in the first 3-5 days post-op. There was considerable swelling and bruising. The first time I looked at it which was the day after my surgery was actually quite shocking. I couldn’t believe it was actually my body. I’m not a big fan of taking pills and tried to accept the pain as much as possible. After two days I caved and took the prescribed pain killers that were given to me. It was just too unbearable, and I consider myself to have a very high tolerance for pain. Still, I took them sparingly as I really dislike taking pills of any kind but Tylenol and Advil just weren’t cutting it for me. It took me two days post-op before I had a bowel movement which was also quite painful with a lot of blood. The prescribed painkillers made me constipated which didn’t help at all. The pressure of the stool pushing against my sphincter muscles was unbearable. It took me about 5 days for the swelling and bruising to go down and about a week and a half before I no longer needed the prescribed pain killers. It’s now 13 days post-op for me and I don’t require any pain killers what so ever and the swelling and bruising is gone. My stitches have completely dissolved, they actually dissolved after about a week. I am now left with a large gaping hole right on my anus where the incision was made. It does drain, but to me it appears clean with no sign of infection. I know it’s meant to drain fluid but I’m worried about it being so open and how that works with it healing. I hope it doesn’t heal oddly and I’m left disfigured. I’m not sure if it’s normal for it to be so open. I realized yesterday that feces actually gets trapped in the incision opening after a bowel movement and I have to lay in my tub with a mirror and a squirt bottle and carefully angle the nozzle to spray out the feces that gets collected in it. Never in my life would I ever imagine myself having to do such a thing. After I realized that though I’ve been cleaning it out that way after every bowel movement. The external opening of the fistula still has a considerable amount of draining coming out of it and it seems to be closing up but the tissue is red. I don’t know it that’s normal. I take regular long baths twice a day. I try to avoid using a sits bath as I find them to be quite painful. It puts a lot of pressure on my sphincter and wound area and also cuts off the circulation in my legs. I just have a lot of regular baths instead. I still keep the external opening of my fistula covered with a 2″ x 2″ gauze double stacked under a peice of Hypafix. My external fistula opening is about two and a half inches up on my butt cheek from my anus so I need to actually have it covered with some sort of adhesive bandage because the gauze won’t stay there on it’s own. I’ve been using the hypafix since day one and I find it comfortable and clean. I have relatively sensitive skin and as long as I change my bandage on a regular basis and keep the moisture to a minimum there isn’t too much skin irritation. Like I mentioned it’s day 13 for me and I do see improvement. I still have about a month before I have a follow up visit with my surgeon. I guess I’ll find out more then. The positives are the swelling, bruising and pain are gone, both my wounds look clean with no sign of infection, the pain right now is very minimal and my bowel movements are no longer bloody, still painful, but not bloody. These are all positive things. I can’t wait to be able to put this all behind me and I just hope this procedure works.

      • Hello Stephanie,
        Thank you for sharing your story. IM scheduled for the LIFT surgery in the fall. I have my seton since April 2014. I cant wait to get rid of it…It’s not easy to manage work, husband,kids, soccer and sizts bath! :-)
        Work is the worse..siting all day drives me crazy!
        My CS is not sure he will be able to do the surgery because the fistula seems very high (50% of y muscles)
        Was your’s high also?
        I hope your surgery is a success, after so long dealing with this you derserve it :-)
        cathy

  12. Hi, I had a fistulotomy February 25th. Pain wasn’t too bad although the pain pills helped. I eased back to work but am still having drainage and sitting issues. My fistula began a few years ago and after 6 years of dealing with abscesses, er visits etc, finally went to ColoRectal guy. Had a draining seton for 8 months and finally had the fistulotomy. Question-how long before the opening heals.? I know it’s different for everyone but sick of dealing with the wiping issues and the drainage….

  13. Please help I’ve had 5 surgeries from the flap to the plug which I just had on 3-28-14 I am in extreme pain the area is swollen and hard I went thru a lot of bleeding and then the next day no blood but the area is very tender and hard.i think the plug didn’t work and I just want to know if this is normal,the doctor said it looked good and it was normal.I need to know if this is normal the swelling and pain under my testicals that this happens while the plug is accepted into the body .Please if any one can tell me anything let me know.

  14. Hi, I had an abcess back in Januray 2014, drained and left open. Went for a follow-up appointmnent.. bad news fistula.
    Had surgery on April 10, 2014 and woke-up with a red rubber seton. This is used to drain pus.
    Went to the general surgeon yesterday and found out that the fistula went trough both muscles… He suggested to keep the seton and wait for the drainage to stop.
    I was on Flaggyl for 7 days (Last day today.. Thank God). Once the drainage stops???
    First option: He wants to take it out, this can take a few months I guess… than take it out and wait to see if it will heal.???
    Second option: wait for it the drain and do a fistulotomy cutting both mucles, fixing the fistula and sowing the muscles back??? This scares me
    Anyone had the same procedure.

    I am from Canada Québec.
    Very stressed and sad
    merci
    Cathy

    • Cathy,
      Make sure your surgeon is conservative and experienced. Cutting the large sphincter muscle (especially in women) can cause fecal incontinence. If your fistula only passes through the small sphincter muscle, the risk is much lower but may result in uncontrolled flatus.

      If you’re able to travel to Toronto, I would recommend the LIFT procedure by Sandra de Montbrun at St. Mike’s. She has a very high success rate.

      Recovery was hard for 4 weeks but it’s much less invasive than a fistulotomy.

      Best of luck!
      J.

      • Hello J,
        Thank you for the info. My GS refer me to colorectal surgeon in Montreal. I will be asking if the LIFT is an option for me.
        I will not be going with the cutting of the muscles, i’m really to scared!
        My post Op went well, the inflammation is all gone (6 weeks)
        Cant wait to see the CS and hope he can heal me.
        Hope you are doing well.
        If my CS has no experience with the LIFT, I will call yours.
        Cathy

    • Cathy,
      If it is going through both muscles you need to see a colorectal surgeon. You are at high risk of incontinence if a fistulotomy is performed. You need sphincter sparing surgery like LIFT or Flap or even plug. Get a referral from general surgeon to see a colorectal surgeon. Trust me!

  15. hi am pradeep 15days before i am having fitsula surgery . now i didnt went to motion properly in daily any tips for this issues??

  16. This is to Stephanie’s reply above – don’t worry about “disfigured” too much, I had a fistulomy/lectomy and I was shocked a chunk of my flesh was gone, but it grew back 95% in 4+ months now (I do read that it takes about 2 years for wound to be 98% back to near original flesh condition) at the beginning when I went to the local wound clinic, they kept saying I had a fistula because of stool coming out from where the fistulomy/lectomy was done but after 1+ month that wound/hole healed and no more stool came out. So I imagine it’s just normal healing process so you shouldn’t have to worry too much.

    It’s funny how wound healing works, I had 2 wounds – 1 is from the fistulomy/lectomy and it healed 80% during the 1+ month then it sort of stopped leaving a small cliff-like (by this time no blood) and when I push on it it hurted (scar tissue) compare to my normal skin. Then end of 3rd month it started healing a bit again.

    My 2nd wound is from a big abscess (orange-size per Mt. Sinai surg ) this one is still healing 4+ now, the drainage hole healed 95% by month 3+ and since the small 1 or 2mm diameter stayed the same (thank god actually, so it allows natural drainage) <– This 2nd wound was a reinfection 2 days after the 1st surgery …. it was also from a surgical miss because Rudd clinic didn't take it seriously with no pre-op analysis decided to take a chance under EUA… that landed a 2nd infection more complex type of abscess (ischio) … the doc there was never able to explain me what he did and i just saw him keep re-interpreting the notes he took while recording on his tape and in the end he confused himself…. so yes big hospital is safer than private outpatient clinic in my experience

    Mine is also a sinus, no internal opening found yet from 2 exams, going MRI in sep. I read a study sinus has more recurrence than fistula because it's hard to pinpoint the root cause of infection

    I decided to leave it for now (2-3 sitz baths a day seem to help) I have no pain, just drainage (yellow, pink) and just 1+ week ago the drainage suddenly reduced from a Toonie size to penny and the wound seems dryer than 1+ week ago

    I'm still monitoring and learning as I go

    but I have a feeling that i should trust my body a bit and give it a chance to work out the reconstructuring by itself — from what I learned,,, sometimes you go to surgeon/doctor they'll just straightaway suggest to operate on you as a means of resolution and remunerations (win/win for them) … (surgeons are humans too so I can sometimes see them panic hence why suggest surgery…) but in the mean time the body might be taking its time to heal slowly

    So I agree w/ all peers here dealing w/ this for a while – yes sometimes great deal of patience is required

    Alright, take care Stephanie – let's hang in there


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