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Old 09-21-2009, 05:51 PM   #1
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Nancy07 HB User
anal fistula surgery

Has anyone had anal fistula surgery? Or seton placement? I have had an anal abscess for 3 months and they turned it into a fistula and put a seton through it. I am infected again, and wondering what I'm on for next?

 
Old 09-22-2009, 09:44 PM   #2
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JanuaryJ HB User
Re: anal fistula surgery

Hi Nancy07, my husband has had the seton placement, it was his 3rd surgery for treatment of his anal abscess. We are waiting for the seton to work its way out. The doctor told him, that after the seton falls out, the abscess should have closed/healed. If not, the next phase is to 'filet' the tunnel so that it heals flat. I hope this helps, regarding steps.... if you need to talk, I understand! God Bless you!

 
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Old 09-23-2009, 02:45 AM   #3
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Re: anal fistula surgery

I don't think my seton will fall out, it's a loop, fastened together in some barbaric fashion with two thread ties and a piece of the seton sticking up at one end. Ugh. I could be wrong, but I think he said they would pull it out later if it worked.

The doctor mentioned an anal flap technique as a possible alternative, but that his limited success and can affect fecal continence.

I have read about the "filet" tactic - apparently one major drawback is that is can affect fecal continence, because they are cutting the muscle.

It all sounds pretty grim to me! If your husband has to have the filet method, his chances are probably better than mine, this whole thing happened to me after I had my entire anal muscle sewn back together after it severed during childbirth. So my continence is questionable already!

 
Old 09-23-2009, 05:45 PM   #4
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Re: anal fistula surgery

Hi Nancy... I am scheduled to have my fistula repaired next Wednesday and I am having terrible anxiety about it. How long were you laid up for? I have a sub for Wed Thurs and Friday.. was hoping to be back on that Monday.. Do you think that will be enough time? I had my first abcess in May... but have had about 4 of them since. I know I need this done.. just really nervous about it. Did you go home after your surgery or did you stay in the hospital?

Laurie

 
Old 09-24-2009, 04:15 AM   #5
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Re: anal fistula surgery

I think it depends on what type of fistula surgery they are doing. My surgery wasn't so bad, they actually created a fistula out of my abscess, to help it drain, because it only had one outlet. And they put a seton loop in it, which doesn't hurt either.

The pain wasn't so bad, after a day or two I was much better. But I'm not working these days, I can't imagine working while hardly being able to sit down! But I think that's because of the pain from the infection, which is pretty bad. When the abscess isn't infected the pain is much less. (it's infected 5 times in 3 months).

Are you a teacher? I used to be, and I'm wondering if I will ever be continent enough to teach again. Good luck with your surgery!

 
Old 09-24-2009, 08:54 AM   #6
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Re: anal fistula surgery

Thank you... I have been really stressing about this recovery process.

 
Old 09-25-2009, 09:19 AM   #7
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Re: anal fistula surgery

I have been dealing with a high fistula since May 2008 and it has literally been a PITA. It started with an abcess that then turned into a fistula. I have had 4 surgeries (one to drain abcess, a draining seton placement, a failed plug placement and another draining seton placement). The first draining seton was in place for about 6 months after which the colo-rectal surgeon tried to permanently repair it with a fistula plug. My body rejected it and it ultimately caused a lot of swelling and tissue damage around the internal opening. I have had another draining seton in place since January 2009 and am scheduled for advancement flap surgery on October 15. I'm REALLY hoping this works because coping with this problem affects daily life more than anyone knows. I have had to wear guaze pads and a sanitary napkin 24 hours a day for the last 16 months. I've spent so much money on guaze pads and Kotex I've thought about buying stock. The fistula continues to drain so it is something that requires constant attention. I have done a lot of research on this and there are very few websites with information pertaining to permanent fixes. I am seeing a top colo-rectal surgeon at the Cleveland Clinic in Fort Lauderdale who is involved in several case studies and research and he even says that the doctors take it all on a case-by-case situation. He is reluctant to cut in that area since it may require cutting of the sphincter muscle and possible incontinence. This next surgery is going to involve cutting a flap inside the rectum and sewing the internal opening closed. Not sure what they do with the external opening but I will find out. What I have found is that all fistulas are different and all doctor's opinion's on repair are just as diverse. One recommendation is to ensure that you have a very good colo-rectal surgeon who you are seeing due to the sensitivity of the reqion. I definintely sympathize with anyone out there who is dealing with this issue. Not exactly a party conversation starter, that's for sure!

 
Old 09-26-2009, 06:17 PM   #8
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Laurieivy HB User
Re: anal fistula surgery

Quote:
Originally Posted by Kristing View Post
I have been dealing with a high fistula since May 2008 and it has literally been a PITA. It started with an abcess that then turned into a fistula. I have had 4 surgeries (one to drain abcess, a draining seton placement, a failed plug placement and another draining seton placement). The first draining seton was in place for about 6 months after which the colo-rectal surgeon tried to permanently repair it with a fistula plug. My body rejected it and it ultimately caused a lot of swelling and tissue damage around the internal opening. I have had another draining seton in place since January 2009 and am scheduled for advancement flap surgery on October 15. I'm REALLY hoping this works because coping with this problem affects daily life more than anyone knows. I have had to wear guaze pads and a sanitary napkin 24 hours a day for the last 16 months. I've spent so much money on guaze pads and Kotex I've thought about buying stock. The fistula continues to drain so it is something that requires constant attention. I have done a lot of research on this and there are very few websites with information pertaining to permanent fixes. I am seeing a top colo-rectal surgeon at the Cleveland Clinic in Fort Lauderdale who is involved in several case studies and research and he even says that the doctors take it all on a case-by-case situation. He is reluctant to cut in that area since it may require cutting of the sphincter muscle and possible incontinence. This next surgery is going to involve cutting a flap inside the rectum and sewing the internal opening closed. Not sure what they do with the external opening but I will find out. What I have found is that all fistulas are different and all doctor's opinion's on repair are just as diverse. One recommendation is to ensure that you have a very good colo-rectal surgeon who you are seeing due to the sensitivity of the reqion. I definintely sympathize with anyone out there who is dealing with this issue. Not exactly a party conversation starter, that's for sure!

 
Old 09-26-2009, 06:26 PM   #9
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Re: anal fistula surgery

Hi Kristing... wow you have been through the ringer as they say. I am sure hoping that this works the first time. Did you have to stay in the hospital for any of these surgeries or was it all out patient? I have had about 4 abcesses since the first one in May '09, so figured i should get it fixed... The doc did mention that if it is too deep he will have to cut the sphincter.. and that just plain scares me to death since I won't know what has been done until I wake up from the anesthsia...I am hoping not to go home too soon as I have a lot of stairs in my house... I don't know.. will this effect my walking? How well will I be able to get around? Will I just have to lay down? If you don't mind my asking Kristing, how old are you? Im 52... much to young to have incontinence, not that any age is good for that... I am wishing you well on your Oct. 15th operation... I am having mine on September 30th Yikes... only 4 more days... I will post how I feel when I can.

 
Old 09-29-2009, 09:55 AM   #10
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Kristing HB User
Re: anal fistula surgery

Laurieivy- I am 39 years old; also WAY too young to think about incontinence. Luckily, I have had only one abcess that progressed after a high fall directly onto my buttocks from a chair. I believe the trauma from the fall led to the abscess which led to the fistula. I had a swollen lump on my right buttock for several months before it surfaced and started bleeding and I finally went to the doctor. Post surgery for the abscess debridement and seton placement were relatively pain free. However, following the debridement (before they diagnosed a fistula) the open wound had to be packed daily and my poor husband was stuck with this job for three weeks prior to seton placement. It involved using the stick end of a one sided q-tip to insert a long strand of gauze into the opening and all the way to the end of the abscess. This was quite painful for both of us but I usually took a percocet prior to having him do this. For me, this was the most difficult part of it all. All of my surgeries have been out-patient. I have experienced discomfort for about 24 hours after each of these surgeries but nothing too serious. Walking was never a problem; sitting was a bit tender for about 4-6 days. I did experience a great deal of pain following the plug placement but doctor said it was due to early onset of infection and rejection by my surrounding tissues. I am totally thinking of you and sending positive vibes your way for your surgery on the 30th. Let us know how it goes. Unfortunately, the research is not promising when it comes to permanant treatment of these types of fistulas. I'm trying to stay positive but it's very difficult when thinking about the next step if this doesn't work. I've got my fingers crossed for both of us and realize it could be much worse. Good luck and keep us posted!

 
Old 10-02-2009, 10:24 PM   #11
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Re: anal fistula surgery

I had my fistulectomy with seton placement on Wednesday the 30th. I had more trouble with the General Anesthesia than anything. They had trouble putting the breathing tube down my throat. I have a huge blister on my lower lip and the roof of my mouth is bruised with a very sore throat. I have been following the dr. orders on taking the stool softeners and nothing has happened yet and I am miserable.. I have a very swollen hemmoroid on the outside with a twist tie looped through my anal wall and perineum. I have been on a high fiber diet.. it is starting to really hurt. I have to go back into surgery on the 22nd Oct.. to put in a plug. He said he would be using Pig flesh. Ok... so hopefully that will be the end of this nightmare. Can somebody share with me how soon did you have a bowel movement after your seton placement. Its been over 48 hours for me. This is a total PITA...

 
Old 10-04-2009, 03:34 PM   #12
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Re: anal fistula surgery

I have a high fistula too. Have had it since early 2008. Started in late 2007 as an absess which ruptured. My Gyno thought it was an infected gland and treated me with antibiotics. Of course it wouldn't heal. To make a long story short, I just got my 2nd drainage seton Oct. 1. I have had the fibirin glue, the fistula plug, a drainage seton, a flap repair in July which did not take. I was devastated... that is what leads me to my new drainage seton. I don't know what the answer is. I would rather have the seton than the constant infections and pain. I do hate the pads and cottons and gauze too.

Please let me know how your surgery goes. I hope it is successful for you. I don't know what my options are at this point. I just want to leave the seton in for as long as possible this time. My bottom has had enough trauma for now. Please keep in touch.

 
Old 10-26-2009, 12:30 PM   #13
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NCGIRL38 HB User
Re: anal fistula surgery

Quote:
Originally Posted by stephoz98 View Post
I have a high fistula too. Have had it since early 2008. Started in late 2007 as an absess which ruptured. My Gyno thought it was an infected gland and treated me with antibiotics. Of course it wouldn't heal. To make a long story short, I just got my 2nd drainage seton Oct. 1. I have had the fibirin glue, the fistula plug, a drainage seton, a flap repair in July which did not take. I was devastated... that is what leads me to my new drainage seton. I don't know what the answer is. I would rather have the seton than the constant infections and pain. I do hate the pads and cottons and gauze too.

Please let me know how your surgery goes. I hope it is successful for you. I don't know what my options are at this point. I just want to leave the seton in for as long as possible this time. My bottom has had enough trauma for now. Please keep in touch.

 
Old 10-26-2009, 12:36 PM   #14
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Re: anal fistula surgery

Hi, I am new to the boards but am experiencing a fistula too. I have had it for 2 years and started out with the the plug surgery which did not take then had a draining (not cutting) seton inserted in December. The seton has helped immensely with the infections but the constant draining is very annoying. I am now scheduled for the Advanced Flap Replacement surgery on November 5th. I too am very nervous about this procedure as it is my last option without having to start over and try the other surgeries again. The plug and seton placement were fairly easy surgeries with little recovery time. With the flap I have been advised that I should stay off my feet with very little activity for at least 2 weeks. KRISTING... I am hoping you can post your experience with the flap before I go in for mine. I can certainly empathize with each and every one of you... a fistula is an embarassing and discouraging condition.

 
Old 10-27-2009, 08:24 AM   #15
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Re: anal fistula surgery

Well, I had the advancement flap surgery on October 15. I had to stay overnight in the hospital which was my first experience with an overnight. That alone was pure hell because I had no sleep whatsoever. The surgery lasted about 2 hours and the doctor said the tissue looked healthy and is hopeful that this will take. I had to have a catheter overnight as well which was not something I was overly fond of! The morphine drip was great and helped with the pain and comfort level; just didn't help sleep since they were checking on me every hour. The pain immediately following the surgery was an 8 on a scale of 1-10. That lasted for about 2 hours and laying in bed was a bit more comfortable since I could adjust the bed to take the pressure off my buttocks. They kept me on a liquid diet for dinner and then I was able to eat soft foods for breakfast and lunch the following day. I was released on the afternoon of the 16th and the car ride home was very uncomfortable (hospital is about 1 1/2 hours away from home). Thinking back on it, I'm glad I was in the hospital immediately following the surgery just in case something went wrong or if infection set in. I asked for a painkiller stronger than Percocet and they gave me Vicodin. Percocet has never worked for me and usually keeps me awake. The Vicodin works VERY well to subside the pain so don't be afraid to ask for something stronger than the Percocet. I stayed home from work for a full week and really did not leave the house during that time. I mostly stayed in bed/on the couch with backside propped with a pillow to keep pressure off of it. They've kept me on Miralax to keep stool soft which helps tremedously because bowel movements are very painful. I chose to stay on a soft food diet for most of the following week since I experienced such excruciating bowel movements after the failed plug surgery. The Miralax has helped and I'm down to taking it every other day and have resumed a regular diet. Bowel movements have gotten easier. The biggest amount of pain has been the anus (stretched during the surgery for two hours) and the external opening of the fistula. They had to cut the external opening from about a 1/2" to about 2" during the surgery. That area was extremely sensitive and painful for about 5-6 days. I had to use a shower wand to really clean the area out after bowel movements. My surgeon recommended against sitz baths since it softens the area up too much. I use wipes after every bowel movement and am still using guaze pads and sanitary napkins for minimal draining. There has been little to no drainage from the external fistula opening which is a huge improvement. My anus still leaks but I think it is still weak from the surgery. I try to keep the area as clean as possible and there have been no signs of infection, thankfully. I went back to work yesterday which entails a lot of sitting and made it for about 6 hours. Thinking back to a week ago, I am feeling much better and am hopeful that this is going to work. I see the surgeon on Nov. 13 and will know better at that time. One area that caused me problems after the surgery was the breathing tube. I must have aspirated some fluids into my lungs during the surgery and deep breathing was very painful up until a couple of days ago. I had a rattly cough which was pretty painful and had to go for chest x-ray to rule out pneumonia. Much better now after a week and a half. Also was on antibiotic Flagyl for 5 days following surgery. I hope this information helps and that your surgery goes well. The prep is not fun especially if they have you use the Movi-Prep solution the day before the surgery. NASTY stuff and you will be on the toilet for most of the evening. I have managed to loss 10 pounds through this all which is awesome! Although I could think of a few more pleasant ways to do it Keep us posted about your sugery. I hope everything goes well and that we're both on the road to recovery quickly! I'm so tired and drained (literally) from dealing with this for almost 2 years!!!

 
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