If you’ve read my previous post op diary thread you’ll know all of the backstory so I won’t relitigate all of that.

My last follow up with the surgeon was 3-4 months ago. At that time I thought perhaps the fistula returned, but he probed the wound and confirmed it had not returned, there was just delayed healing. He applied silver nitrate and I waited for the swelling to get better...

Swelling has basically gone away now. However, RIGHT at the anal verge where the wound healed, there is a very tiny dot that I thought was a hole (like when an abscess first ruptures) but it is not inflamed, just white like healed skin and is NOT draining. Underneath, this area does seem to be filling somewhat. It never gets painful and it never becomes a ball like an abscess would. Looking at it when it’s filled, you wouldn’t know without pressing on the area. The area that feels like it has something in it is very, very small. When I apply pressure, it immediately drains out through my anal canal (aka the hole that you’re born with ). It is typically a small, dime-sized amount. I could press the area once in the morning and once in the afternoon and that would be all the fluid aside from the small amount that leaks naturally.

It is such a small amount that I don’t HAVE to wear any gauze to catch it. If I do, an entire day with the same gauze results in a small dime or less-sized wet spot with very light fluid. It does not have a smell. It also has no tinge of brown or red to the color unless I just went to the bathroom.

It’s clear there isn’t a fistula. However, something is also clearly getting “caught” when I go to the bathroom and will clear out when I apply pressure to the area.

Again, no pain or anything. What could this be? I plan on going back to the Dr soon if it doesn’t stop so I can have it looked at before my insurance resets Jan 1. It hasn’t gotten any better or any worse since several months ago, it appears to be exactly the same.

Anyone else?

Hi,

Well good news that the swelling has gone now. Could this just be mucus that is getting caught in - in what is effect a small cavity? Just a thought. I guess the main thing its to keep an eye on it.

Best, LM

Hi all,

Just following up here. It's been almost a year (feb 22) since my fistulotomy. All was going so/so throughout last summer - you can read about my latest update from September above.

I just scheduled an appointment with my CRS for 1/16. I am afraid I have a problem.

I was going to the bathroom, no straining or any real issue - and when I was wiping I noticed a slight bump right where my fistula was/the healed wound is. Looking at it in the mirror, it looks like I can see where the incision was - I don't believe it used to be this pronounced during the summer but it has been a LONG time since I actually looked at it. It is like a semicircle line, so I assume this to be the incision scar. On the one side of the scar, is the bump. However, it seems to come and go and is not painful at all. It is way smaller than the original abcess was, almost unnoticeable unless you press on it.

I noticed some type of fluid is coming out of the incision scar line. It is VERY tiny, and really only comes out again if pressure is applied, and even then it doesn't happen right away and once a little bit drains out it's difficult to get any more to come out and the little bump seems to become a little smaller/flatter.

I thought I was having a recurrence back in April (2 months post op) because of swelling in this spot and when pressing on it fluid would come out (a good amount). The CRS probed it and it did not connect to the rectum so he applied silver nitrate for over granulation and confirmed I did not have a recurrence of the fistula.

Now, I'm thinking it is coming back because it appears to be something similar to an abscess, though nothing like the first one. My original abscess in December 2016 was large, hard, and painful until it broke open and drained into a fistula. This is nothing like that, at least right now.

I called as soon as I noticed fluid to make an appointment and was disappointed when they couldn't get me in much before 2 weeks. I really hope nothing gets worse in the mean time.

I am not a man of God and do not practice religion but have been praying to myself that this is not what I think it is. I have not had any problems, pain, blood, straining, or anything throughout my healing from surgery so I cannot imagine WHY I would be recurring - I so hope I'm right. I've just done a lot of research on here about this issue and have never heard of something like this happening.

Anyone else experience anything like this, almost a year later?

So sorry that you're still dealing with this after so many months post op. It might be a good idea to get an MRI done so any potential tracts can be visualized. (Not saying you have any!) And maybe get a second opinion as well if your current doctor isn't able to come up with a treatment plan.

I may ask to have an MRI done when I go in for my appointment.

Thank you for the well wishes! My CRS is well renowned in my area, my mom is an RN and seems to know all the good and bad of various doctors over her 30+ years - she recommended him to begin with. Very nice man, caring/gentle. I think I made a mistake by not going in for a follow up sooner when I suspected something might be wrong, but his assurances really calmed me down so I left it alone. Plus, no pain at all so it hasn’t been an issue until I felt the new bump!

Just thought I’d post an update as I wait for my CRS appointment. The bump hasn’t gotten any worse. I’m fact, it seems it may be getting better but on a very small scale. I have been resisting the urge to press on it to make it expel whatever is filling it up. I do apply very slight pressure just to see what happens, and largely nothing. Occasionally (usually after the combination of going the bathroom and then straight to the gym for weight lifting) it will expel some light colored fluid, almost a white color. The amount is almost negligible, I can see about a 3mm diameter dot on the tissue the first check and then nothing. If I apply pressure on the bump after that first check, nothing.

This morning, I noticed the bump was smaller and didn’t have the “head” feel to it that it did last week. It feels as though there is less fluid inside and therefore less pressure. I have tried checking in on it now and then and the fluid that does come out is even less than I described above. There is definitely something going on - 11 months post op shouldn’t have anything like this happening - but I’m holding out hope that it was an abscess that recovered or maybe something else minor entirely.

My appointment is in about a week, I’m sure I’ll either be terribly upset or amazingly happy with the outcome so I’ll come back to update.

Thanks!

It does not sound like a big deal TerrifiedinNY and it seems you're moving very fast. Good luck and keep us posted!

Hi everyone,

I promised to update when I had my appointment so here I am.

Over the last four or five days, the bump reduced in size and drained a good amount all at once (I was examine the area, it was dry, then I looked up to grab a tissue and when I looked back down I had drainage! Didn’t even feel it happen) but still had definition to it. Over the course of a few days it did not drain at all and continued decreasing in size. The spot where it had drained, on the incision line from surgery, was healing back together. As of this morning, the area feels softer and less firm than it ever has - I’m in disbelief.

Explained all of this to my CRS and he said “I can’t explain it, but sometimes the scar tissue can get irritated and may become inflamed. It could become a problem but it sounds like this has cleared without issue.” Then he examined me and immediately said “oh yeah, this is perfectly fine.” And wished me a happy life

I still don’t know what caused it and am fearful it could come back more seriously but for now I will rest easy with the good news!

That's great news! I hope you never have any more issues in that area again

Good news my friend! Enjoy life.