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Old 10-22-2009, 10:17 PM   #1
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Princess Mommy HB User
Fistula repair/sphincteroplasty questions...any help?

I found these boards by google searching after I was told I needed a sphincteroplasty and some other surgical intervention, the exact procedure names were never mentioned and I am ashamed to say I never asked. My story is quite different than any I have read here, and I am hoping to find someone who has had experience or can shed any light at all on what I am going through. I apologize in advance for what is sure to be a lengthy post.

My story began in April of 2009 when I felt a "cyst" on my buttock, but assumed it to be a pimple/boil or other such thing that would resolve itself. It didn't and instead became very painful. After a week or so of painful sitting and unsuccessful attempts to "squeeze it out" (sorry...gross, I know) I became very ill with a high fever and symptoms that I assumed were a flu. After more than a week of being ill, feverish (came and went) etc. I ended up in the ER. My husband assumed I had cellulitis from the mysterious cyst, but I was sure it was the flu so I just did what I was told and drove myself to the ER (husband was at work) where I was diagnosed with a colo-rectal abscess. The ER doc called the colo-rectal surgeon on call who requested an attempt to drain the abscess be made in the ER and then to send me home to follow up later. But once the ER doc started to drain the abscess it was discovered that the infection was much more extensive than thought and I ended up being admitted to the hospital and having an emergency surgery.

The colo-rectal surgeon found the infection "horseshoed" around and the tracts could not be laid opened as he had hoped due to the extensive nature and the muscles involved. Instead, he laid open what he could, inserted 3 seton drains and 3 or 4 penrose drains creating a rectal-vaginal fistula (deliberately) in the process. I was in hospital for approx. 5 days after that on iv antibiotics and pain control then sent home on oral antibiotics for 3 weeks. A month later the penrose drains were removed in the doctor's office, and the setons remained until this month. After several months (until Oct.) of healing I was scheduled for a sphincteroplasty, fistula repair, and whatever else he did to me (he said repair the tissue that had been damaged by the extensive infection).

The surgery was done last week, and afterward he re-iterated what a big deal this surgery was, how much tissue had been damaged and said that he had to re-build much of the perenium in addition to the other tissues. I was sent home after 3 days, with a catheter still in place (was removed the next day) and after-care instructions of sitz baths, Silver Sulfadiazine Cream and gauze dressing (twice a day and as needed) and another two weeks of antibiotics.

Things have been going okay, I guess. I was told to expect at least a month to recover and not to walk, drive or exercise at all for a while. But here is where my questions start:

Everything I have read about sphincteroplasty talks about it as a treatment for incontinence- I never had this (and hopefully won't now) so was this really necessary for me? Obviously none of you can answer that one, but that is a huge concern of mine right now. I do not have Chron's disease (did have a colonoscopy to rule out Chron's and other causes) I did not experience trauma from childbirth and in short have no clue what caused the original abscess. My doctor (colo-rectal surgeon) doesn't know either and doesn't seem all that interested in trying to find a cause- he said that it would be really odd and "rare" for it to happen again.

I was sent home with lots of percocet for pain control, and have been using them as sparingly as possible- taking them at bed time mainly as they make me fall asleep. But I am unsure how much pain is normal or when it should get better, I worry that I might always hurt like this! The pain is (naturally) more pronounced after I use the restroom- is that always going to be a painful experience now? I read one place (one person) that BMs would remain a painful and unpleasant experience after sphincteroplasty forever, but my doctor did not mention that. Also, my doc said there would be drainage and bleeding at the surgical site- and there is, but how do I know what is normal and what is way too much? It seems to be a lot for being a week post-op, I am soaking 4 or 5 gauze sponges a day at least.

Does anyone have any success stories they can share with me? Right now I am awfully scared and hurting, and very worried that I wasn't given all the information prior to surgery. I just did what I was told and didn't ask enough questions I guess but now, after reading the "I survived sphincteroplasty" threads especially I am so worried about what I may have done to myself.

 
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Old 10-24-2009, 07:07 AM   #2
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penny70 HB User
Re: Fistula repair/sphincteroplasty questions...any help?

Hi PrincessMommy,
What an ordeal you've had. I and quite a few other have had sphincteroplasties for very different reasons, mostly childbirth but most of us have had somewhat of a difficult time, leading us to this site as well. I think you're very early in recovery so don't expect it always to be like this. I would hope for the best as far as permanent results until you're out 6 weeks or so. Some people don't feel totally better for some months but most of us felt better after 3 months or so. Having a movement should feel much better over time. I have also had a fistula that took forever to heal but some people have them heal asap with no further problems. I suggest pampering yourself as much as possible until you're feeling like doing more but don't assume the worst. Often things never go that way. Hope I have answered some questions. Maybe some people from the original post will check in with you too. Take care, Penny

 
Old 10-24-2009, 08:21 PM   #3
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Princess Mommy HB User
Re: Fistula repair/sphincteroplasty questions...any help?

Quote:
Originally Posted by penny70 View Post
I think you're very early in recovery so don't expect it always to be like this. I would hope for the best as far as permanent results until you're out 6 weeks or so. Some people don't feel totally better for some months but most of us felt better after 3 months or so.
Thank you for your response, it does help a lot just to know that I am not alone- this isn't something that I am comfortable talking about with many people, so the secrecy/isolation factor makes it difficult too.

My biggest fear is just the pain. Immediately after surgery I was doing great- walking the hallways and in little pain- of course I still had iv pain control on board. It just seems like instead of progressively getting better it is steadily getting worse. I dread using the restroom, and it hurts so much for hours afterward, sharp, crippling pain that is sending me running (figuratively of course) to the Percocet much more than I would like. And today (10 days post-op) I ventured to the grocery store for a quick trip; hubby drove I leaned against a shopping cart and we just got a few things but that trip wore me out. I thought I might pass out waiting in the checkout line!

I have to believe it will get better, I just need it to get better sooner rather than later, ya know?

 
Old 10-26-2009, 04:22 AM   #4
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penny70 HB User
Re: Fistula repair/sphincteroplasty questions...any help?

Yes, I do know how you feel. I think I was pretty much bedbound for over a week so it seems you are really trying hard to get back to normal. I don't think I left the house for weeks after. Give yourself time, pamper yourself. I had a collection of books and videos I watched. Calling friends and family and company really helped. I ended up on Delaudid for quite a while but it helped and there was no addiction problem. Let us know how things are going.
Penny

 
Old 11-06-2009, 07:04 PM   #5
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llstrategy HB User
Re: Fistula repair/sphincteroplasty questions...any help?

I'm really sorry that this happened to you. I had Sphinteroplasty and fistula repair done almost 3 weeks ago due to a 4th degree laceration incurred during the birth of my first child. I think it's important that people who have had successful operations post since it seems that only the people with negative outcomes remain on the boards. It makes sense. Those with successful surgeries have moved on and rarely think about their issues anymore. I would consider my surgery to be a success so far. I was in the hospital for 1 night and came home the next day. My surgery lasted about 1.5 hours and I was on a regular diet as soon as I came home. I take 2 stool softeners a day, and 1-2 tablespoons of metamucil a day. I am on Percocet and ibuprofin and take at least 3 sitz baths a day combined with handheld shower cleanups after using the bathroom. Drainage was pretty bad the first 2 weeks, and I needed to change the dressing 7 or 8 times a day. Part of that is that they think I have an infection and am now on 2 different antibiotics in addition to the painkillers. I had an issue 4 or 5 days ago with constipation and trying to move a really large bowel movement but it resolved itself after some straining (which worried me) but I don't think I've torn anything. Pain level wise, I'm doing okay. I could probably go without the painkillers but I don't believe in suffering for no good reason and my doctor says that not taking the painkillers will force my body to use its resources for dealing with pain instead of healing. I have been in bed mostly for the last 2.5 weeks, but I do go out and do things like go to the grocery store and my husband even took me out to lunch and a movie which I was able to do comfortably.

Some issues I had after the surgery was that I had trouble urinating after they took the catheter out. I had the same problem after I had a c-section. It took a day to recover and I found urinating in the shower with the warm water on my belly was the only way to urinate for a day. Actually, having a hand-held shower head is the single most important thing anyone recovering from this type of surgery can have.

I can drink coffee without leakage. Actually, I haven't had any leakage since the surgery. BM's are somewhat uncomfortable but not nearly as painful as they were in the first 2 weeks. I don't really dread them as I did before. Drainage is near minimal now as well. I'll post again after I see my doctor next week but to be honest, after 4 years of incontinence, the embarassment and the self-esteem issues, I'm very glad I did the surgery. The years to come will be interesting and I hope to continue posting good results. I hope you all do as well.

 
Old 11-21-2009, 10:11 AM   #6
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katp25 HB User
Re: Fistula repair/sphincteroplasty questions...any help?

Hello everyone. I am new to this board. I am schduled for my sphincteroplasty surgery in mid-January. I wanted to wait until after the holidays and my next marathon. That said, you can tell I am an avid runner. I am a triathlete as well and these activities are where my problems have been worst.
My problem's origins are similar to what llstrategy explained. I had a 4th degree episiotomy when my son was born. I pushed for 3 hours - He got stuck in the birth canal with the cord wrapped around his neck and was not breathing when he was born. I thank God everyday that the doctors kept working to get him out and did it successfully as he is a healthy happy very active 8 year old today. My experience with that lead me to schedule a c-section for my daughter 2 1/2 years later. I was terrified of history repeating itself.

Reading some of these stories on here I am getting very nervous. I am in Sales and travel for work occasionally and travel around Houston all day some days visiting customers. As with most big cities, that can mean hours in the car and sometimes not a bathroom very close by if needed. I am very worried how this will effect my ability to do my job. My dr told me that I would need 2 weeks to recover but since I can do much of my job from home (phone calls and emails), I thought that a week off of work and then 2 weeks working from home would be OK. My boss has already said that if any travel trips come up during that month, he would just go in my place and not to worry about it.

I know everyone is different and I am in very good physical shape so was thinking that I should have reason to be optimistic about my recovery time. Am I being naive? I know the infection risk is there and will change the story big time. But I just want to be as prepared as possible. Right now, I know there is a trip I need to take to Mexico 4 weeks after my surgery and reading here, I'm thinking that may not be possible.

Can anyone tell me what would be an optimistic time period to be back to "normal" activities (able to travel) and what is "average"?

Thank you in advance for your help. I found a board like this when I was pregnantt with my son and it was so nice to talk to others going through similar issues and get and give support.

 
Old 11-25-2009, 04:26 AM   #7
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penny70 HB User
Re: Fistula repair/sphincteroplasty questions...any help?

Hello everyone,
Katp25, it sounds like you've been through a lot and are ready to move ahead with the surgery. Everyone heals somewhat differently and I think everyone has slightly different issues to resolve. You may find that 1 week is not quite enough time. I still had difficulty sitting 6 weeks later, and a lot of my job is sitting, but I also had problems with my doctor and his office so that might be an outside recovery time. I would just recommend listening to your body and having someone who can be with you that first week, especially if you have a little one, too. Getting back to work is good when you're ready, but at first you want to focus on the healing. Good luck to you. Having a body is great shape can't but help you through surgery and after!
llstrategy, I'm so glad things are working out for you. It sounds like you're healing well and the operation was a total success. Getting beyond those first few weeks is great. Hope everyone enjoys the holiday!
Penny

 
Old 12-01-2009, 10:29 AM   #8
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NALA75 HB User
Re: Fistula repair/sphincteroplasty questions...any help?

Hi, This is my first time on the site! I found my way straight to your posting after seeing FISTULA/SPHINCTORP...y. ETC..I am 34 and was diagnosed at 24 with Chron's. *My serious problems and alerts started when I started to have pain in my rectum/intestines (90%in anus) which led to such severity that I layed on my couch for 3 day's straight...with only 5 steps to my bathroom i was barely able to walk threre...etc. ***It is time for me to go into the ER to have a DR check me out & HOEFULLY get me into my Gasroenterologist quickly. I haven't had to see my GE in 2yrs, so I am very very scared, upset, mad and in horriable pain down below due to which I am 95% sure is anoher ABCESS,FISTULA& more FISSURES...I WILL GET BACK TO YOU AS SOON AS I CAN WHEN I GET BACK, TAKE CARE...THINK POSITIVE!!!

Last edited by NALA75; 12-01-2009 at 11:27 AM.

 
Old 12-02-2009, 03:42 PM   #9
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mistybear HB User
Re: Fistula repair/sphincteroplasty questions...any help?

Hi, I know exactly how you feel, my son had a huge head and I suffered a 4th degree tear also, that was 18 years ago. I have crohns and developed a fistula that did not heal right, which left me incontinent (I hate that word). After 4 years of dealing with it, I decided now was the time to go for it and quit thinking about it. It has been 2 months for me, and I don't think 4 weeks into it I could of gone somewhere due to the pain I have had. I still am not sure of the outcome, but I really think it has helped some,and it has made me feel better about myself. I wish you a speedy recovery and enjoy the holiday. Take care

 
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