Fistulotomy scar tissue

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Fistulotomy scar tissue

Postby Cporosus1 » 27 Apr 2015, 20:16

For people who have had a fistulotomy and have since healed- did you notice any occasional tightness from the scar area? I have no pain (except for the occasional split second pinch or sting) but I can "feel" where the wound was when I sit down...it feels tight in that area. I've never had any other major surgery that involved a large scar so I have nothing to compare it to. Is this normal? I have no discharge and no bulge...in fact it seems the hard parts of the scar are starting to fade slowly. Also, when do you think it is safe to go back into the spa/pool? 3 weeks ago my surgeon said it was 99% healed and that I should be good to go into spa at 1-2 weeks. I called for another appointment last week to make sure it was fully closed, but they said they didn't think it was appointment worthy so long as I had no drainage or major pain. There is a minor "weird" discomfort occasionally, can't really describe it....not pain, just a weird feeling. I assume this is all normal. I am probably having anxiety for nothing; I don't have Crohn's or anything else and I'm a young, healthy powerlifter, so I assume I should be in the 95% that don't have recurrence hahaha :)
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Re: Fistulotomy scar tissue

Postby msimon » 28 Apr 2015, 02:24

I would think that tight feeling is normal at this stage. I am noticing something like that myself in the area I had 'unroofed'. My pelvic floor physio is itching to get at the area and mobilize the scar tissue. I wonder if you should do some gentle massage of the area to try to loosen it up a bit. Adhesions are bad news because tight tissue doesn't stretch well and could lead to tearing. Where exactly is your surgical area (was yours a simple fistulotomy)?
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
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summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Fistulotomy scar tissue

Postby Cporosus1 » 28 Apr 2015, 02:35

Hi msimon...yes it was a simple fistulotomy. The scar tissue extends about 2 inches or so from my rectum, getting thinner as it approaches the rectum itself. This looks like most fistulotomies I have seen. It was a fairly deep wound but not deep enough to warrant a seton nor anything else. Is your wound healed yet? Mine took about 13 weeks to fully heal.
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Re: Fistulotomy scar tissue

Postby msimon » 28 Apr 2015, 02:40

Thanks for asking. Nope, not healed yet. I am on week 11, I think. Had a big setback last week with lots of blood. Physio thinks an adhesion in the tissue let go. I think the new tissue is really weak from having 2 surgeries in the area in only a 3 month time frame. CRS said it may bleed on and off for years because of this! I hope he is wrong.

Since it was simple then you should be able to work all the new tissue/scar tissue quite easily. My physio says to just take your finger and do gentle circular massage on the area to keep it mobile. It really needs to be able to stretch down there.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Fistulotomy scar tissue

Postby Cporosus1 » 28 Apr 2015, 02:44

Sorry to hear about the set back...is it getting close to the surface? My surgeon never mentioned anything about massaging but I have heard that mentioned in regard to scar tissue before, I wasn't sure if it was recommended for rectal scars, but it does make sense that it would help. I think my regular doctor might be able to help me better with scar questions than my rectal surgeon, he is highly talented but fairly quick to just say "it looks great, your fine, don't come in unless you're having discharge or serious pain" hahaha
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Re: Fistulotomy scar tissue

Postby msimon » 28 Apr 2015, 20:02

I can't really say as the incision area is underneath some swollen skin flaps and I dare not pry since the bleeding last week. I had a comparatively small area excised as it wasn't a true fistula yet but am healing so slowly. CRS says it's because it becomes more difficult with each surgery in the area. I am assuming it is still healing. Will wait a bit before looking further.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Fistulotomy scar tissue

Postby Cporosus1 » 28 Apr 2015, 23:33

Hi Msimon,

My wound was healing fastest when I felt a weird tightness during the period from week 11 to week 12. Whereas prior to that I felt little of anything, the wound just seemed to come gradually closer to the surface...but between week 11 and week 13 everything just shrunk and closed up remarkably fast. It felt really weird and towards the very end there was some pain (the last tiny bit which hadn't healed was being irritated when I went had a BM) but that too healed completely by week 13. Now it has been around 16 weeks and it is just some tightness in the scar tissue and a weird kind of tiny "keyhole" looking groove at the point where the fistula met the rectum, but my doctor saw this and mentioned nothing about it, so I assume it is normal. I never had much drainage at all, even immediately after the surgery and none later on, I'm not sure why. No incontinence either.
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Re: Fistulotomy scar tissue

Postby richibeno » 30 Apr 2015, 12:19

Hi I'm 2 1/2 years down the line
I had botox for a fissure which infected an anal glan which turned into an abscess '
This turned into a fistlua '
Had the bop to clean out abscess may same time inserted a draining Seton '
2 months later it had healed enough for a fistulotomy it was quite high '
Even Now I feel discomfort now and then and I have quite a bit of scar tissue'which become sore mow and then''it has left me with. A creese in my anal canal which sometimes hold some debris after a bm And I have
to go for a clean up an hour or so later '
I think once you have had one of these you are never the same again
Keep it soft
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