I just had a fistulotomy surgery yesterday and thought I'd share my experience, since I've been reading other people's stories the last couple weeks.

About 3 1/2 months ago I developed a very painfull abscess. It was especially painful after going to the bathroom and sitting. Eventually it grew to the point where I could barely get any sleep at night, but then it burst leaking out lots of blood. It immediately felt a lot better but not completely. I was still feeling some pain so a few days later I went to see a GP. He said it was a boil and would heal on its own with some antibiotics. I have suffered with boils in other places for 15+ years so I didn't even question the diagnosis.

Another couple months went by sometimes it would feel better but sometimes would flare up again (also something boils do) so I went to see a different GP. This one said he could see no signs of a boil but there was open skin that he thought was a fissure. He prescribed some stool softener and fiber supplements plus told me to keep gauze or tegaderm film over the wound to help it heal, and to call back in 2 weeks if it wasn't better. I called back and he referred me to a colo rectal specialist.

I went to see the colo rectal Doctor and almost immediately they said it was a fistula originally caused by that abscess a few months ago. They said fistulas almost never heal on their own and it would need surgery. Obviously I wasn't thrilled by the idea but it seemed like the only solution plus from reading online it seemed the longer you leave a fistula untreated the worse it can get.

I scheduled a fistulotomy or seton placement with follow up fistulotomy (they wouldn't know until they fully examined it) for a couple weeks later. I was pretty nervous about the surgery reading some of the horror stories online about some people having 8 or more surgeries but I also read clinical studies that seemed to have high success rates and also realized that many people whose fistula had healed probably didn't stick around forums as much.

So yesterday I finally had the surgery. I've had some other surgeries for pilonidal cyst and the procedure from my viewpoint was pretty much the same. Change into gown, get IV in hand, ask and answer a few questions. Then get wheeled into operating room and lay on stomach. They start the anesthesia and that's the last thing I remember.

I woke up in the recovery room sort of half on my side half on my back. Apparently I had "only" needed a fistulotomy and not a seton with a later fistulotomy. They made sure I was able to drink some water first then gave me a Percocet since I was feeling a little bit sore even though they had used local anesthetic in addition to the sedation. Maybe an hour later I was allowed to go home.

I got home and ate some beans (fiber!) and took another Percocet which they had instructed me to do. I also drank a lot of water since I was very thirsty after fasting before the surgery. They also told me to stagger ibuprofen a couple hours after the Percocet. The pain really wasn't too bad with the help of the pain meds, at least laying in bed on my stomach. It hurt a bit more to move or walk around but not nearly as bad as I was expecting. I was able to get 10 hours of sleep overnight just waking up once to take pain meds.

I took my first shower and sitz bath today after waking up. I'm not sure the sitz bath actually helped with pain at all but I know it's also meant to keep the area clean so I'll definitely keep doing it. I was dreading my first BM which I had about 6 hours later. It was fairly painful with some light bleeding but not a lot (none in the bowl). It was a pretty hard BM though probably from a combination of the pain meds and the fact I wasn't able to drink water before the surgery and was also unable to use my Metamucil and docusate since they have to be taken with water. I took another shower and sitz bath afterwards and an hour later was pretty much down to the pain level I was at before the BM.

Obviously it's still very early days but so far this process has gone better than I thought it would. I wouldn't want to sit for long or move around too much but it already hurt to do that even before I had the surgery.

Hope you're doing well today and keeping on top of the pain. to the forum!

3rd day of recovery (2nd day post-op) was pretty similar to the day before. Still sore especially when moving around but I was able to stand for about 4-5 hours and had some relatives over for thanksgiving. It was uncomfortable but not unbearable. BM still pretty painful and again had a little blood and pain for an hour afterwards.

4th day feeling a little bit better. Able to move/walk around a bit more with less pain. Able to lay on my side relatively comfortably and even my back to some extent too. BM still pretty painful but a bit less than the day before.

5th day of recovery feeling better than the day before. Haven't taken any Percocet today, just ibuprofen. Again able to move around more comfortably than the day before. Still not going to be walking really fast or doing jumping jacks, but can walk around fairly normally without a lot of pain. BM still a bit painful but not nearly as bad as the first couple days, and by the time I rinse the area and take a 20min sitz bath it is back down to the level it was before the BM. Virtually no blood with BM either which is encouraging, but still some on gauze pads. I would say it's now only a little bit more painful than it was before the surgery, and less painful than the original abcess that caused all of this.

Savaici wrote:Hope you're doing well today and keeping on top of the pain. to the forum!

Thanks for the welcome and well wishes. It really does help to know you aren't the only one who has had these problems. It's not really something most people would talk about normally, for obvious reasons!

Hi Panindabutt I think you are on the road to a full recovery soon , you are doing the right thing , like I said on the other post that i have been through alot of surgeries on last Sep on the 3th I had sphincterotomy and 3 skin tag removal one of them is huge and after 11 days I developed a fistula and right next day my surgeon had to do a fistulotomy it was a long deep wound , so had to be very clean , good diet , packing the wound and I use to put on it (Monuka honey U20+) my surgeon requested ... and with the help of the members on this lovely forum everything get healed and I m normal right now except for the Pilonidal cyst , so just hang in there and all of this thing will be a history , sorry about my English lol . I wish you a fast recovery

Have you experienced any incontinence? I have been told that it is a huge risk factor with fistulotomy and I am having one in two weeks so I am terrified

It's been awhile since I've checked in (11 days since my surgery now) but I have just gradually getting a bit better as the days go by. Still a bit sore especially when sitting but less than even the "good" days before the surgery. Still a bit of blood and drainage on gauze pads but the Dr said that was to be expected. Almost no pain with BMs now. Still doing 3-4 sitz baths a day and always after BM. My first checkup appointment is in 9 days so hopefully it will be good news but so far seems to be healing well.

nfinch wrote:Have you experienced any incontinence? I have been told that it is a huge risk factor with fistulotomy and I am having one in two weeks so I am terrified

Nope not at all. My surgeon said the chance of incontinence was low for me since I am young (30 years old) and otherwise relatively healthy. From my understanding the risk also depends how much the fistula goes through the sphincter muscle. If it goes through too much of the muscle they should use a seton instead of doing a full fistulotomy. A seton basically very slowly cuts through the fistula over a period of weeks or months allowing the muscle to regrow behind it, to minimize risk of incontinence.

I know how you are feeling though. I was scared and very nervous before the surgery. The waiting was actually worse than the surgery and recovery has been in a lot of ways, at least emotionally. At least now I know I should be on the path to recovery *knock on wood*. All the medical studies I've read show a 90-95% success rate with just 1 fistulotomy so chances are you will be okay. Good luck with your operation!

Thanks, I've actually had a seton for about a month now but it'a not the cutting seton that your talking about its just seton to keep the wound open so that it can drain. Maybe if he can't do the fistulotomy he may have to do a cutting seton because I am running out of options

It's been awhile since I checked in again, but I had my checkup appointment 3 weeks ago (was 3 week after my surgery) and they said it seemed to be healing normally, and still having some some drainage and light bleeding was normal. They also used some silver nitrate to promote healing of new tissue which didn't feel too good, but if it will help heal it was worth it. I had increased bleeding/drainage the next few days after the silver nitrate and some black stuff which they said would happen.

It has been 3 weeks since that checkup appointment now, and 6 weeks since the surgery. It's still not comfortable sitting for long periods of time, especially on harder chairs. Driving is actually okay though, because my car seat sort of leans more weight back towards the tailbone. Still rinsing and doing sitz baths after bowel movements. Still getting some draining, and light bleeding after maybe 1/3rd of BMs, not really painful though. Last week during a sitz bath what looked like a big clot came out and there was a moderate amount of bleeding (more than I had seen since the surgery) which got me worried so I moved my next appointment forward a week (it's tomorrow). Since that bloody sitz bath things have been back to "normal" though. Just light draining and light bleeding with some BMs. I guess I'll know more tomorrow. They'll probably use silver nitrate again which I'm not looking forward to...but as I said if it helps then it's worth it.