Hi everyone,

You may have saw my diary on the first page of my recovery. I stopped writing 45 days post op as everything was going well.

I now have another appointment on Tuesday next week because I'm very concerned. The swelling around where the sutures were significantly decreased after the last stitch fell out. However, there is still swelling after a BM but drains quickly and by 8 hours later very little to no drainage appears until my next BM.

This wouldn't concern me in and of itself as it seems like this is just how it goes as you're healing. It has gotten better over time so I wasn't too concerned. However, as of 2 days ago I noticed that in the healing wound, I suddenly have a new very small hole which very much resembles the original external opening re-appearing on top of the scar. The wound itself is not 100% healed so drainage does come out of the area very close to the anal verge as it has since surgery, but the new hole appeared in a spot that is essentially on-route to the still healing wound. It does drain fluid if pressure is applied to the area nearby where it still swells after a BM. Now, it's not a hard lump at all. Barely applying pressure I can feel the air/fluid pushing out of the still healing wound inside my rectum as well as out of the external opening that's healing and the new hope that is en route to the still healing wound.

I guess I'm concerned because why would a hole reappear if there is already an exit for the drainage in terms of the still healing wound? The new hole is probably 2mm away from the still healing wound. I did not experience a new abscess! Does anyone else have any experience with this post fistulotomy?

I'm hoping at worst my CRS will apply silver nitrate as I've read about and maybe it's just delayed healing. I'm freaking out over it though, I cannot afford ANOTHER surgery and taking any more time off of work. I don't have IBD or Chrons and my fistula was superficial and low. It is in the posterior 6 o'clock position, and I have heard that is a harder area to heal.

Just looking to find out if anyone experienced anything similar and hoping it ended up being nothing requiring another surgery

Time can only tell the recurrence of a fistula... But if there is recurrence you will feel like how it used to be pre surgery. Cant assure you about the recurrence but the silver nitrate thing is for over healing extra flesh that appears on the wound which is called over granulating wound or simply proud flesh. It is overly red in color, extra soft and can easily bleed.

Just in case I scared anyone after documenting my good recovery with this post..

I did make an appointment for this Tuesday but am thinking of cancelling it. On the other hand I may go anyway and have piece of mind - worth it for a $40 copay.

I had 2 more BMs since this post and haven't had much trouble. I think my diet was leading to difficulty passing a BM and causing some trouble. I upped my water intake and watches what I ate the past few days and swelling and drainage has been pretty minimal. No discomfort either. So, I may have been overreacting. We'll see.

It will be worth it for some reassurance at this stage, since I haven't seen the CRS since 2 weeks post op.

I am also in a freak out mode- just saw surgeon for two week post op Thursday and he felt all ok- but I have a lump under surgical area and sometimes I really feel it and it scares me. I walked a lot yesterday and I am in agony today. I imagine it is normal scarring, or maybe a hemm- but I worry.

Probably just swelling from the new tissue. Totally normal, should gradually go down. If it starts to get hot or painful more than now, then there could be an issue. For now I'd say sounds normal!

ugh- thank-you for quick response! I have to call tomorrow and set up my next appt for four weeks away, but I may find out what their week looks like just in case.
Did you go thru something similar?

Yes, I was and still am swollen where the sutures were. Once they came completely out/dissolved the swelling went way down but is still there. After a BM it would be especially swollen but never painful. Light pressure on the area surrounding it would result in drainage.. the drainage never smelled or looked infected but from reading seemed like white blood cells from the healing wound. It would be worse after a BM and exercise, which is my morning routine. But in making it routine I can see over time it is getting better. In fact the last 2 days I've had a morning BM and very little swelling or drainage. Even though it hasn't been painful for 5 weeks now, it must still be internally closing up and thus less swelling and drainage over time.

I had no suture- "layed open" I guess- but obviously skin trying to figure out what to do. Your notes make me feel better about things. A few days of little pain made me cocky and of course surgeon is like "Do whatever". I have not had much drainage since first ten days. I guess that is diff w/procedure they did. I haven't really exercised much and had an initial surgery in January, so I need to just accept some pain and get moving. I hope you feel like tiny hole is healing. On my first surgery I had silver nitrate applied twice. ox

Thanks! Mine was laid open too, but he sutured it because of the posterior location and it was a little deeper on one side than he anticipated. It definitely takes time - even the best doctors don't tell you how long it really takes. It just becomes more routine and really not that bothersome for the last few months of healing but is still there, so I feel like doctors disregard that it's not really fully healed :)

that's what is hard- my doc basically sent me on my way at two weeks. I am embarrassed to go back with a question, but also don't want this to get away from me.