I am having a fistulotomy and I am extremely worried about incontinence. I am a 28 year old female and I know that the risks for females are higher. Has anyone experienced this?

Hi and Welcome to the forum!

Do you know what type of fistulotomy you are having (simple vs. complex)? That is, is your fistula superficial or complex deep?

It is superficial and he wants to try to do a LIFT procedure first but if he can't then he will do a fistulotomy. He didn't specify between simple and complex

I saw in another post that you had a seton placed previously. Is that correct? I believe this makes it a complex one (as in a 2 part process). I really don't know much about the LIFT procedure but I had a simple fistulotomy. Mine was very superficial and I had no incontinence issues after, just like many on here. Your CRS would know the risk for that as it all has to do with proximity to the sphincter. I wish I could be of more help. All I can say is that this is not an elective procedure. There is not other cure for a fistula other than surgery. The best thing you can do is make sure you have a very experienced surgeon doing your surgery. Do you know his/her track record for these procedures?

Yes I have a seton right now for 6weeks. My surgeon said if when I am under anesthesia the risk for incontineence is more than 5% he won't do the fistulotomy and we will have to discuss other options. He comes highly recommended and I trust him but I'm worried about not knowing which procedure he is going to end up doing when I'm under. He keeps saying the fistula is superficial so I'm hoping that it is a simple procedure and no incontinence at all

5% is very low. Has he indicated what type of incontinence we are talking about here? Often, at least with LIS, they say it's to gas or my CRS said 'at most you may get a skid mark'! I still to this day laugh at how he kept a straight face when saying that. Like it was a technical term or something! lol.

Yes he mentioned the gas would most likely be what would happen but I am a graduate student and don't want that Happening during my classes. I appreciate you responding. It's been hard for other people to understand what I am going through

Yeah, we totally get it here. I really wish our culture/society didn't make such a big deal about bodily functions. Really causes a lot of people unnecessary grief.

Hey nfinch

I also had a fistulotomy like msimon. Mine was superficial and considered a simple one. I also was finishing up a grad program when I had mine and am a female. I later only had increased gas due to the increase in fiber too keep things soft. But it wasn't like I was having excessive gas in class and any that I had wasn't loud or noticeable. Rather a little "wind" here and there. I have no issues at all post surgery, I am 1 yr and 6 months out.

Sounds like you have a wonderful doctor from what you describe. He is not willing to risk too much without evaluating you and then speaking to you if he is concerned. The risk for incontinence is really low and they have come SO FAR in surgical techniques to avoid this..... Hence the very low rates.

When is your procedure?

That's so great to hear because I am extremely hesitant. My surgery is scheduled for December 21 and as I said before he is hoping to just do a LIFT procedure but if the fistula is too close to the muscle he would have to do a fistulotomy. The LIFT has a 70% success rate so I am hoping whatever he does works. Now I am wondering why he isn't just going straight for the fistulotomy...