Hello everyone,

I am a newbie to this forum; pls pardon me if i am not following any "best practices" of the forum.

I had my Advancement Flap (endorectal) surgery performed to rectify RectoVaginal fistula 5 days ago. I had a medium-sized passage that was very low/close to the anus. The CRS surgeon said surgery was success and she was not able to see any opening after the surgery . I had BM after a day of surgery, my urination is normal, i am on pain-meds and the pain is slowing subsiding.

But today, unfortunately i started passing gas leakage form vagina as well as anus Does this mean that my surgery was a failure? How long would it take fro the procedure to heal? Should i go through the same procedure again to close the passage?

I am unable to control my tears. Please advice/guide/help me out.

THanks in advance

Coldcoffee - I'm so sorry you didn't get a response right away. How are things now? I haven't had this surgery but had a fistultomy and had strange experiences until further into my healing. Hope to hear how you are doing. Sending healing vibes your way!

Manitourose wrote:Coldcoffee - I'm so sorry you didn't get a response right away. How are things now? I haven't had this surgery but had a fistultomy and had strange experiences until further into my healing. Hope to hear how you are doing. Sending healing vibes your way!

Hi Manitourose,

Thanks for the vibes, received :)

I am still i pain. It is exactly the 14th day after surgery, but things havent imporved. I met with the CRS yesteray and she said the flap has moved up a bit creating a passage (~ 1 cm), but she said it "might" heal on its own and she is a hopeful person; but i am not I dont know if this wound will heal and the passage will close on it own.

To make matters worse, i still see some stool (liquidy goey) (forgive me for the gross details) coming form the vagina. Infact 50% of the pasty stool (once again apologies for the details) from vagina.

I lost all the hope now. I honestly do not know if the hole will close on its own. All i could do now is cry

Is there any chance you could get a 2nd opinion from another CRS or chat even with your OB/GYN? I know the OB isn't the CRS, but you really deserve feeling heard at this point and likely she has had patients who have gone through this and voiced their experiences. It's nice that your CRS is hopeful, but she did the surgery and her #1 priority is your comfort right now. She either has encountered this before and has a range of stats of how often it heals on it's own or she doesn't. You absolutely deserve the option to know and make a choice on waiting or having a repeat surgery.
Do you know why your doctor choice the advancement flap surgery over other methods? I'll do a little research myself to learn more too.

We are 100% here for you and please feel free to PM me too if you want to email and need someone to chat with. Know that how you are feeling is totally OK. Sending huge hugs!

ColdCoffee, so sorry for what you are going through, and I would second what Manitourose said about getting a second opinion. One of the mods on the forum had the very surgery that you have had and I will send her a message and see if she might come by. Thinking of you.

Manitourose wrote:Is there any chance you could get a 2nd opinion from another CRS or chat even with your OB/GYN? I know the OB isn't the CRS, but you really deserve feeling heard at this point and likely she has had patients who have gone through this and voiced their experiences. It's nice that your CRS is hopeful, but she did the surgery and her #1 priority is your comfort right now. She either has encountered this before and has a range of stats of how often it heals on it's own or she doesn't. You absolutely deserve the option to know and make a choice on waiting or having a repeat surgery.
Do you know why your doctor choice the advancement flap surgery over other methods? I'll do a little research myself to learn more too.

We are 100% here for you and please feel free to PM me too if you want to email and need someone to chat with. Know that how you are feeling is totally OK. Sending huge hugs!

Thanks for the response; much appreciated.

The fistula was located so close to the anus; also the rectal wall was so thin for me. The CRS said ERAF is the best way to fix it (we did not do full analysis of all the procedures available and read online that AF has a very high success rate) and we approved it. Though the CRS said that there can be failures, she said it has 85% success rate.

Sadly my OB/GYN is leaving out of town and i have to find a new one. Has anyone on the boards have every faced similar ordeal with this surgery? I glanced through the forums, but couldnt find any related info (my search queries might have been poor, i have to admit).

Savaici wrote:ColdCoffee, so sorry for what you are going through, and I would second what Manitourose said about getting a second opinion. One of the mods on the forum had the very surgery that you have had and I will send her a message and see if she might come by. Thinking of you.

Thanks for the support, Savaici. Much appreciated.

It would be hugely helpful if i could converse with the mod. Im sitting inside 4 walls and have zero social life right now and I am really feeling lonely. More than the loneliness, im afraid i may have to go through the same process again (repair surgery) to have this fixed again. Im losing patience and extremely sad. This is such a painful thing to have (after one of the happiest moments in my life, my son's birth 6 months ago)


Edit 1 : I would also like to apologize if i dint follow any forum netiquettes in posting responses; is it ok to "quote" while replying?

Hi, I had double advancement flap surgery a few years ago, it was for anal stenosis not a fistula though. It's a rough surgery and takes a very long time to recovery from. My donor sites were left open after surgery so the scar tissue wouldn't pull as much after everything was healed. Infection and tissue rejection were the biggest obstacles to cross. I wouldn't think being able to pass gas through the vagina is a good thing. Your doctor should recheck that and if necessary do another flap if the first one isn't taking. This can sometimes happen. Keep asking your surgeon questions and if you're not getting good enough answer get a second opinion. Like I said before this surgery takes a long time to fully recover from. I didn't heal for months and then after I did initially my CRS said it would take 2 years for things to settle down and he was right. If I can answer any questions for you please feel free to ask. Suzy

How are you now? It’s been years and after reading this I really hope
You’re well