I just happen to have one I can spare
Saw the surgeon this afternoon. The bad news is that I have a fistula; the good news is that I don't have a classic cryptoglandular fistula, but rather a iatrogenic fistula, which means that it was caused by the LIS. The incision site healed the wrong way and now has to be deroofed. That's good news because classic cryptoglandular fistulas typically involve sphincter muscle, whereas the surgeon thinks mine is low enough that the fistulotomy shouldn't involve any muscle cutting. So there you have it (or rather, I do!)
I really like my surgeon! I'm so glad I had a fit. This guy is awesome. He spent a whole HOUR with me, after hours! (I didn't get out of his office until 6pm.) He examined me and then took my history and we talked about everything. He is scheduling surgery for me for sometime in the next few weeks - he is booked until September but he is willing to perform the surgery during off hours. I LOVE this guy. He has very little use for the Rudd Clinic, as it turns out. He will perform the surgery with a GA and will look around a bit to make sure his orginal diagnosis is correct. It's like he adopted me and he's going to make sure that he finds anything wrong with my GI system. I am so happy to finally have a REAL surgeon!
And ... I'm scared of the surgery, but relieved too. I go back and forth between being happy that the worst happened and it's not so bad, to being completely freaked about another surgery. Okay ... mostly I'm kinda scared of the surgery, but glad I'm getting it ... oh drat I don't know what to feel!

Hey there, it sounds like you'll have a similar procedure to what I had. When I had my post-LIS abscess, my official procedure was a "perianal abscess incision/drainage with fistulotomy". That's what it says on my hospital paperwork verbatim.
In my case, I asked the surgeon afterward whether I had a fistula. She said nope, no fistula tunnel, but she did debride the edges of the abscess area so that one wouldn't form. My abscess was caught at just under 2 weeks after LIS, so maybe yours had a bit more time to develop since it wasn't caught until a bit later.
(On a side note: some fissures, if left untreated, can also become fistulas. That's what happened with our member "afugh!" and a couple others from the past.)
Anyway, this is good news. Not good in the sense that you have a fistula, obviously. But good in that they're doing the right thing, which is short term pain for long term gain. The #1 most important thing IMO when it comes to ass issues is initiating appropriate treatment. Personally I think a lot of us would have been saved a lot of trouble if our fissures had been treated appropriately while they were in the acute phase (i.e., using fissure ointments instead of wasting valuable time slathering on counterproductive garbage like hydrocortisone), and likewise, your surgeon is saving you trouble in the long run by doing the correct surgery right now instead of screwing around and attempting a "Hail Mary" with antibiotics.
Let us know when you have a surgical date! If your abscess surgery is anything like mine, the aftermath should be pretty similar to LIS. Although here's to hoping that your actual abscess surgery is far more compassionate and by-the-book than the handiwork by the LIS dude!!!

P.S. Ok totally unrelated topic, but I'm seeing my urologist this Thursday to schedule my awesome adult circumcision! If it's ok, maybe we'll be surgery recovery buddies! You recovering from the backside, and me from the ummmm yeah ahem you know :)

P.P.S. Just saw that you're going under GA for the fistulotomy. That's great news! Thank goodness this new guy is a lot more sensible

Hi Hope-
Bummer that you have to have more surgery. But it sounds like you caught it early and found a surgeon you like. Having somebody you like and trust makes the whole process less stressful - at least it does for me.

Sorry to hear you have a fistula, Hope. It's good to hear you are having a better experience with this new doctor and your fistula isn't deep!! This doctor sounds much more professional and caring. Thank God!
I know it's has to be scary going into another surgery but this may have been the reason you were experiencing more discomfort and now you will be headed in the right direction! Thank goodness you caught it early!!

Here's some hugs for you!
Aww, sorry to hear it's a fistula, although not surprised. They say 50% of abcesses turn into a fistula - but has any of us ever had one that didn't turn into one???
That's wonderful you have a surgeon who you trust - it will truly make all the difference in the world if you know you're in good, capable hands. You got through LIS , and in horrific circumstances, you can get through this too. I won't say it's a walk in the park - you've had LIS, so you know it isn't! But it isn't any worse than LIS. And you will be safe and secure knowing that you will be healing and that there is light at the end of the tunnel.
My fistula formed the first time because my fissure had healed wrongly and created a roof over it, so it sounds pretty similar.
At least you'll be under GA! That will make a HUGE difference! Geez, you've been through MUCH worse with your Dr.Death surgery - a fistula is nothing compared to that!
The worst part will be the waiting. I was freaking out all the time that it was making tracks - by the time of the surgery I was convinced that I was going to look like a Swiss cheese inside and be riddled with tracks but of course, it wasn't. Reading online, people have been dealing with one for years, and not done anything about it!
You know any danger signs to look for.And September isn't too far away, easier said than done, but relax, take it easy, and try to look forward to the surgery and see it as your final step to healing.

Hey NG! We should definitely be surgery recovery buddies! Wow - an adult circumcision! You are MY new hero now :D
I recall you talking about getting that done a while ago in your earlier posts, but I forgot why. I won't make you explain everything again, unless you want to. I can re-read your older posts.
Definitely let us know when youre surgery is scheduled. You have an upper endoscopy coming up soon, don't you?
Thanks for sharing the info about your experiences. It does sound very similar, except that mine had time to form a complete tunnel. I am very glad that I'm getting this fixed properly by a surgeon who isn't insane. I will have to re-read Afugh!'s posts too.
You are so right that too many of us spent precious time screwing around with hemmie creams. I actually had to diagnose myself and go to the torture clinic because regular doctors kept giving me flippin' hydrocortisone cream, which I'm sure made the situation much worse. Doctors!
But I'm determined that I will recover from this surgery well and get better as quickly as human biochemistry allows. I wish doctor Crusher would beam me up to the Enterprise and just point her little dermal regenerator at my ass and I'd be fixed - sorry, I'm a Star Trek TNG fan! (It's a good thing, too, because I expect I'll be watching a lot of it over the next little while!)

Thanks so much Paul, Dawn and Val -
You are all definitely right that having a surgeon you trust makes all the difference. I'm actually not really all that scared about the surgery. The recovery is what mostly has me more nervous; but, as you say, I've been through the LIS, so I can get through this. And I survived Dr Death, so I think I can handle this one. Also, this surgeon wants to follow up with me once a week, so there will be none of that "am I healing ok?" and "Am I ok?" anxiety that follows the surgery. I am so grateful I met this surgeon :D
I asked him if it's possible that this fistula will track elsewhere and he said that it is highly unlikely - usually that only happens when there is an underlying condition (although I'm sure it's not unheard of).
Val - have your doctors given you any explanation about why you developed a fistula again? Could it be because you keep fissuring and perhaps a new fissure healed in the same wrong way that your first one did? It would be nice to have an explanation! Maybe there is something they can do about it. The Swiss Cheese butt scares me too (what an image!) But I don't think that'll happen to either of us :D
How are you doing today? I hope the pain is subsiding by now and you are beginning to feel more healing everyday

Hey Hope,
Haha good memory! My upper endoscopy is scheduled for this Friday morning. Not looking forward to it, but figure oh well, what the heck. It's at 7 AM in the morning and I'm going to be completely under using Propofol so it should be a walk in the park.
And yeah .... the ummmm adult circumcision lol. It's from a yeast infection due to all the sitz bathing I did after LIS. How's that for irony eh? The yeast infection comes and goes, so it's not there all the time, hence why I've been lazy about the surgery. But it's a recurring pattern, and I'd like to get rid of it once and for all if possible, so soon I'll taking my shot at fame and fortune ... errr well may not, just a functioning penis would be fine.
BTW I'm actually a huge TNG fan too hahaha. And to a lesser extent DS9 (I stopped watching that one after Odo became human though). Dr. Crusher is HAWT in a MILF sort of way, second only to Deanna Troi on that show. And maybe Tasha Yar before she got eaten by the tar monster and came back as a Romulan lol. My fav character is Data, though, I actually have a Halloween costume for him Other personal favs: when Picard became Loquitous of Borg, when Lore and the Crystalline Entity battled the Enterprise, and in DS9 the Worf-Dax romance with the "rugged fun sessions". Guess we'll have similar surgery recovery entertainment too!