Hi everyone, I had a fistulotomy about 11 weeks ago which itself was about 8 weeks following the drainage of an abscess. I am a healthy 31 year old man without Crohns or any other disease which may influence such things. I think the problem arose during period where I have a small cut in my perineum and was in bacterial filled water working for a few days in Belize. My question- it has been 11 weeks and I am still not fully healed. Discharge and drainage mostly subsided by the 2nd week and there has been little if any pain at all (I was able to sit after 2 weeks as well). My surgeon simply layed the track open and did not put a seton in and he did not say I needed to see him again after the follow up appointment unless I had a lot of pain or a fever. It has been healing and in the past week I have noticed a lot of tightness in the area and it appears to have closed up a significant amount just over the course of 48 hours. Is this normal? Right now all that remains is a small, shallow open wound that is pink in color about 3x3 cm or so and a small line going into my rectum. How much longer would you guys say I have? My surgeon told me that there is a "small" chance of reccurrence and online it seems it is around 7%. I've never had a fistula or abscess before this and I hope never to again! My field work requires me to be in humid, tropical environments where access to sitz baths is not possible, so I need to recover! I have work planned for July and it is late March now.

I'm trying to recall how long it was before I had full healing. It took awhile and I had the same procedure more or less as you. You mentioned you don't have access to take baths, have you not had access during your healing period? Only curious because your healing time may simply be slightly slower due to not having the opportunity to do those. I know they promote blood flow and also keep the area cleaner. I would say you are probably coming along in the healing process, just slower perhaps.
I definitely have had twinges of "tightness" as you describe, I think (not sure) its the wound closing and creating small amounts of scar tissue.
Eventually you do turn a corner with healing and magically you aren't thinking about your bum as often, but it takes time. I can 100% relate!
Hang in there and just keep healing the best you can given your life/work. Its the very best you can do for you and it will come along. :)

Thanks Manitourose,

Over the 3 days since I posted this things have changed rapidly. Right now all that remains is some redness where the wound was and a tiny, tiny shallow hole right next to the anus at the end of the wound redness. Just 3 days ago where it looks like red normal skin now was white and pink (my surgeon said that was normal healing stuff...not pus). I read that the average healing time for our procedure was 12-13 weeks with a grace period of 4 weeks in each direction. I usually heal quickly and I'm healthy. I HAVE been continuing my bodybuilding/powerlifting routine since 2 weeks following the surgery (my surgeon said it was fine and that only swimming should be avoided). I have been washing the wound down with my shower head after literally every single bowel movement, which has been very tiresome and annoying but it gives me peace of mind. I've also been using unscented and alcohol free wet wipes to wipe the bowel movement since they were painless and less harsh than the reg. toilet paper. Have you had any problems since your wound closed up? Even though I'm basically at the end of the healing I'm now starting to stress and have anxiety over recurrence, even though I know the chances are very low.

No issues as far as the fistula since it closed up. I've dealt with a fissure, but I think I have had them on and off but was never diagnosed. I only learned it I had a fissure when I went into a new doctor (I had to keep moving cities for clinicals). But mine was relatively easy to treat with increased attention on fiber, water, becoming less stressed and using prescription cream. However, I of course was paranoid about a reoccurrence of a fistula but the CRS said all looked well. I have read the recurrence rate is generally higher in botched surgeries when the track isn't strategically opened by a someone trained in a fistultomy, higher up/complex fistulas and with those that suffer from irritable bowel diseases such as Crohn's. I can't help that when things aren't perfect I panic and my common sense goes out the window. Actually, I'm sure I could "help" the panic but I'm working on that! :)

So glad things have picked up in your healing and you soon will be on your way feeling back to normal without worry in your job! My doctor said the same thing as well regarding swimming but all other activities were fine. Good to hear similar advice.