Repair of anal keyhole deformity after fistula surgery?

Fistula surgery, fistula, incontinence, anal leak, keyhole deformity, fistulotomy, fistulectomy

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Repair of anal keyhole deformity after fistula surgery?

Postby May » 29 Dec 2015, 11:17

I had fistula surgery on the 31st of July 2015 and I seem to have been left with a gutter/groove in my anal canal that leaks after bowel movements. Has anyone had any kind of repair for a keyhole defect??

My backstory:
It was a shallow fistula with a longish tract so my surgeon performed a simple fistulotomy/fistulectomy (they don't seem to specify in the uk). I was convinced prior to surgery I had an extra tract branching off, but he seemed to think it was just the one. I even had a scan done with a private surgeon and nothing else showed up (though I don't think it would as the problem seems to be in my butt cheek).
Healing all seemed fine and was going well. I had a minor setback when I realised he hadn't discovered an extra branch of the tract (painful butt cheek and more pus leaking out of the anus two weeks after surgery, yay!). I saw my surgeon and he said the wound wasn't infected. He didn't seem to believe me about the extra tract, but said we couldn't do anything about it, so let everything heal up and we'll go from there.
Healing continued okay (I even started to believe him when he said the pus may have been the wound closing too soon). I went on holiday, I was in no pain. The body fluid draining from the wound was annoying, but it was gradually clearing up. I had no trouble with incontinence or leaking.
On the 9th of September, I had food poisoning. I was going to the toilet about 4 times a day for four days. On the third day I started leaking stool after bowel movements and the surgery site felt sore. (Perhaps I re-tore it? No blood though) At first the leaking was instantly after a BM (I assumed it was just inflammation) then it was half an hour after. Now it's 1-2 hours after but has never gone away.
I've seen my surgeon, and I've ditched him and gone with a new surgeon. Both didn't seem to think I have a keyhole defect, but I can feel it myself. Gross I know, but there is a definite gutter in the anal canal with no soft anal cushioning - just a groove of scar tissue which seems to be acting like a 'slide' for leftover stool in the rectum/anal canal. I'm going for more scans and tests. The new surgeon does believe I do infact have another tract branching off - with no external opening. It leaks pus about once every 2-3 weeks, but as there is no external opening, it leaks into the anal canal. I also seem to have a slightly damp anus all the time - like digestive mucus is also able to leak out of the groove.
I have been tested for Crohn's (colonoscopy and blood test) and it came back negative. I'm now wondering if I should be tested again. I have IBS (am also intolerant to pulses it seems) and as my fistula surgery didn't seem to 'fill in' I'm wondering if I should get tested again. I have a chronic fissure too, but it doesn't hurt. It is just a tear that won't heal. If I were a surgeon I would be pretty reluctant to cut through someone's sphincter if they already have a tear which never healed. I wish I'd just had a seton thread.
The one thing I really want to know is if anyone has been through a similar experience? I'm throughly depressed with all of this now. I can't find that much info on keyhole defects online - some sites mention transferring skin into the anal canal to fill the gap. Has anyone had this done?
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Re: Repair of anal keyhole deformity after fistula surgery?

Postby Savaici » 29 Dec 2015, 20:07

Welcome to our forum. I can't advise you on this, but can give you a link to posts on here that may be of some help to you.

Also, I can give you the name of a very good CRS in London, who has seen and treated a few of our members (Mr. Windsor).

Here is the link. I hope someone else will come along with some advice: search.php?keywords=Keyhole
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