Hi Everyone!
Just wondering if anyone here has had a fistulotomy, and if it was successful. I have had a fistula for almost 2 years now which, for the most part, is quite manageable, but can be extremely painful every so often. I have had a few opinions from top CRS Drs. One said a fistulotomy would be fine, another said he wouldn't do a fistulotomy, only a seton. I think I would go to the Dr. who would do the fistulotomy if I decide to have the surgery after all. In the meantime, I can handle the fistula, but I know one day I will need surgery, so I am hoping to hear some of your experiences. Thanks so much!

Hi Motherluch,
I'm going to give your post a bump.
We have a few boardie's who recently had fistula surgery.
Hopetoheal, Adam and Val.

Hi Motherluch,
I had a high fistula which the whole thing was laid open. I questioned this yesterday with my doctor as I thought high fistulas had to have setons. He said that they think now that setons dont really work.
A fistulotomy will get rid of the fistula and stop the painful fill up/pain/discharge cycle. I had a fistulotomy 3 years ago - a superficial one and it healed up fine.

I have my fistulotomy scheduled for this Thursday. Mine is superficial (no muscle involvement) and will be done in the CRS's office along with Botox for the fissure. I'll update after my surgery.

Hi Motherluch! I had a fistulotomy on June 27th. I had a low, superficial fistula (it was actually caused by my LIS incision healing over, and so it had to be deroofed ). I'm one month post-op and healing well (KOW!).
I think a lot depends on how high the fistula is. From what I've read, high ones that involve a lot of muscle require a seton, but lower ones that don't involve a lot of muscle can just be laid open with a fistulotomy. Maybe you should ask your CRS's for more information about what kind of fisula you have. From what I understand, there a different kinds of fistulas:
Superficial fistulas don’t involve sphincter muscles; intersphincteric fistulas form at the “intersphincteric plane” (between the internal and external sphincter muscles); trans-sphincteric fistulas travel from the intersphincteric plane and go through external sphincter; suprasphincteric fistulas penetrate the sphincter muscles and go around the external sphincter; and extrasphincteric fistulas connect the rectum to perineal skin but pass external to sphincter. I’ve pasted a link below to a website that I found helpful for understanding different kinds of fistulas. The low ones (superficial and intersphincteric) are the most common.
http://www.medscape.com/viewarticle/475289_3
As Val suggests, new knowledge develops all the time, and good surgeons keep up with things, so I think this is definitely something to ask your surgeons more about.
I hope this helps!