
Hi Dewlily,
Thanks for posting and welcome here.
Sorry to read of your fistula issue and your stress in dealing with it, but once they've started the surgery route for you, you'll be on your healing path sooner than you think!
I'm a little confused by your surgeon's assessment that the fistula tract is so long - I thought an abscess would be normally drained directly from the site anyway? Do you have a secondary external opening close to the rectum now?
I think the only way a surgeon can really know for sure is when they perform the examination under anaesthetic and can confirm the exact location & size of the tract - that's when they'll decide the best course of action - either a Fistulomy for a more superficial fistula or a seton insertion for one that interacts with the sphincter muscle.
Your CRS should be able to give you all the fine details once you've come round from the anaesthesia!
If I inserted more pressure on my fistula at that time, I too, would make it ooze more!....which I hoped always would get rid of it all quicker, only it never did until I had surgery to get rid of it once and for all!
I'm not convinced that you will be lying on your stomach healing for 6 weeks! Either procedure above will leave you in a few days of discomfort but nothing too major. I think most of us fistula patients spent a couple of days with more bed & sofa rest but were up and moving around quite normally very soon after. The average time to go back to work ranged from a week to about four, so hopefully, it will be like this for you too...
I didn't actually take painkillers whilst I had my fistula - for me it was just an annoying experience with more pain when the fistula became inflamed again and then that horrid pus/ itchiness. I took some Ibruprofen once or twice after the surgery but I wouldn't say anything was painful enough to warrant really strong painkillers. Hopefully, Ibruprofen will see you through...
As long as you just continue to eat properly with enough fibre & lots of fresh fruit, salad & veggies and lots of fluids - you should be fine. Stewed apples/ soft fruits (tinned prunes etc.) gave me really soft stools as do beans! You could always take a stool softener if you feel you need to??......
No, your CRS is right - Your wound may not need packing and it's probably a bit easier when you don't have to worry about doing that daily. They will possibly place a tiny little gauze in there after they operate, which may well fall out later in the day...but after that, just leave it open to heal. You can always place a little pad in your underwear for a day or two straight after your surgery because the wound might bleed a little initially, but that will stop. You may need to get your wound checked during the healing process just to ensure it is healing properly but recovery is not so bad.
Try not to be terrified about all this because fistulas are treatable and the majority, extremely successfully. I had mine over 2 years ago and now, barely remember it (although it was horrid at the time) and no sign of recurrence since.
Surgery is the only way to get rid of them, no matter how much you might not want it and I tried so many things to heal myself! - Just read some of the success stories in Fistula surgery here and hopefully, you'll feel a lot more encouraged & relaxed about it all. The surgery is OK, very straight-forward and very, very quick! It passes in a flash.....Honestly, deep breaths and you will be fine
