Morning everyone,
Just found this site and thought i should join, im in 2 minds whether to have this surgey or not, really worried im going to make things worse for myself and dont know what to do.
Due to have sugery in 12 days but unsure if i should go ahead, I have a fistula and have had it for 9 months, infected only once at the start and now it just fills with blood and fluid and pops about once every 2 week, i went to see a consultant last week and he offered my sugery to be done in 18 days and to also have banding done for my haemeriods at the same time.
The fistula is a bit of a pain and it does hurt but not all the time, the haemeroids and just a pain to live with but dont cause me any discomfort....so is it best to just stay like i am or is it best to have the op while things are not to bad....do i make it all worse by having the op or will it make it better??
Feel a bit stuck on what to do for the best..:(
Any advise would be great..i dont want to wake up wishing i happent had it done.
Di x

Hello Di, and welcome. I'm sorry you have to be here, but it's good that you are because there are lots of great people here who can offer great support and advice.
I have no experience with hemmie surgery - hopefully someone with experience there will chime in. I had a fistula that was caused by the incision from a Lateral Internal Sphincterotomy (LIS) that healed the wrong way. The LIS healed my fissure, but unfortunately the incision site closed too quickly, which caused a low, superficial fistula. I had a fistulotomy on June 27th and I'm very glad I did it. The fistula is now healing nicely and there is no pain anymore. The first week post-surgery was not much fun, I'll admit, but it wasn't too terrible either (at least compared to the agony of the fissure!). I was feeling about 90% normal by the third week post-op, and I'm now 99% back to normal at 7 weeks. I should point out that I'm recovering from more than a year of suffering from a fissure, losing a lot of weight, losing my health generally, dealing with extreme pain, anxiety, and then two butt surgeries :D So I expect that recovery would go better for someone who has the surgery when they are in better shape than I was in.
From what I've read, fistulas do not heal on there own, so the only way to get rid of them is to get the surgery. That said, surgery is a very personal decision. You will know when you are ready for surgery. In my experience, it is easier to make decisions about surgery when I know as much as I can about my condition and the risks and benefits of the surgery. Did your doc tell you what kind of fistula you have? Is it a low one or a high one? Did s/he describe what kind of surgery you will have? Will it be a simple fistulotomy or will a seton be placed? Did s/he describe the possible complications? I think the answers to those questions might make the decision easier.
We are here to talk it out with you and support you in whatever decision you make. :D

Hi there Di,
I've had two fistula surgeries - a high one and a low one. As Hope says, they cannot heal and do need surgery. In fact they can track to other organs.
In my opinion, it's better to tackle them whilst they are small, but of course, it's your decision.
Best of luck,in whatever you decide!

Hi Di,
I haven't had any surgery yet. I just wanted to add that I will definately be saying a big YES when my time comes. I am waiting for more investigations and then some botox. If the botox fails ? 50/50? I will grab the surgeons to take me to theatre gladly!
There is a lot of information on here to help you decide.
I hope it makes ur decision easier!!
All the best!

Hi Di,
I haven't had the fistula, but I've had the pph hemmorhoid surgery and two rubber band ligations. I'm currently recovering from LIS surgery for a fissure. The pph was excruciating for me and I was out of work for nearly a month. That said I have two co-workers who had the same surgery with very little pain. They were both back at work in about a week. The banding procedures were much better as far as the pain factor is concerned. Just a little soreness afterwards and felt like I was full. I'm not sure why my first surgeon insisted on the pph instead of the banding (in hindsight, I think he just wanted to squeeze more $ out of me). Because of the pain I've been in since that procedure I can't even get a colonoscopy unless I'm under b/c of the pain. My newest surgeon opted for the banding procedures to take care of the hemmorhoids I still had since it would be less invasive. I still had to be under for the procedures, but it was much less expensive (and honestly worked better than the pph). You probably won't be in much more pain with the banding than you are on a bad "flare-up" day. Surgery is always a hard decision to make. I tried exhausting every avenue (diet changes, lost 45lbs, sitz baths, otc meds, etc) before opting for surgery because for me those things did not correct the problem. What helps me make that decision is by writing down the pros and cons for having it vs. not having it. If the pros for having the surgery outweigh the cons then I have it. Hope you feel better soon and good luck with your treatment, no matter what course you choose.

Thank you to every one who posted back...have been in tears this morning with worry..:(
Ok so when i went to see the consultant he explained the procedure and said there are varying depths but i didnt even know what a fisture was and it was all a bit of a blur at the time, i thought it was an ingrown hair....but he did say that they wouldnt know how deep it was until they inject blue dye into it...i have since looked into the fistula and understand it alot more but i still have questions and still feel unsure??
I have been visiting the doctors about a soreness inside for 4 years on and off and feeling up inside myself i felt what i and my doctors thought was scar tissue from a tear from childbirth...but since i have found out (last week) that it is something called a fistula and found out more about what a fistula is i have had another feel and from the site of the opening spot on the outside of my anus gentle feeling slowly up inside it tracks this apparent line where i thought it was scar tissue so it seems apparent that for the last 4 years this fuistula has been slowly working its way down to my anus opening, how high up it goes i have no idea, but i am hoping this means it is a (A) fistula or i think someone on here said a low one, im still learning and im not quite sure what it all means??
I have no idea what a LIS is or a pph....i do not understand the pros and cons of surgry and i have no idea if i really do need to have this done and what would happen if i didnt?? im scared and worried and i dont want to make things worse by having the surgry but dont want to leave it and make it worse..:(
So confussed atm...i know that this is classed as minor surgry but nothing down there hurts so i spose im feeling a bit strange about making it hurt or making it worse??
If i have the surgry will i get another fistula?? can they spread if i have surgry?? do i refusse to have it done if it is a deep fistula as it can do something to the musscles?? 9 days till i have this done and im so unsure :(
Thanks..replys would be gratefully accepted

Hi again Di! I know how worried you are. Many of us here have been in tears and have even had to take anti-depressants and anti-anxiety meds, so you're not alone. But please try not to worry!
I'm not a doctor, so please take everything I say with the appropriate grain of salt. :D
First - "pph" is a kind of surgery for hemorrhoids (Procedure for Prolapsed Hemorrhoids, if I'm not mistaken). It's supposed to be less painful than traditional hemorrhoid surgery, but is still painful nonetheless, from what I've heard.
Second - "LIS" stands for lateral internal sphincterotomy. This is an operation to heal an anal fissure. It involves making a small cut in the internal sphincter muscle so that a fissure can heal. It sounds crazy, but it is quite successful. :D
But, since you don't have hemorrhoids or a fissure, neither of these two surgeries are important right now for your case.
The operation you are thinking about is a fistulotomy. I had that on June 27th and it was a breeze!
If the fistula is low, then that means it doesn't track through the sphincter muscle, or it only tracks through a very small amount of spincter muscle. In these cases, a simple fistulotomy usually solves the problem. The doc just cuts it to lay it open and it heals like an open wound would.
If it's a high fistula, then that means that it tracks through the sphincter muscle. Much of the time in these cases, the doc doesn't want to do a simple fistulotomy because cutting the sphincter muscle could cause continence problems. Instead they insert a seton, which is like a string that slowly cuts through the sphincter muscle, like cutting cheese with a string, but so slowly that the sphincter can heal back again. This usually avoids continence problems. However, sometimes docs will do a fistulotomy for high fistulas instead of a seton - that's what Val had. They make the decision during the surgery, when they can get a better look at what's going on.
As far as the pros and cons of the surgery, I think that depends a lot on your symptoms and what caused the fistula. It won't heal without the surgery. In some cases, fistulas can form secondary tracks and spread, but I believe that's more common when there is an underlying condition, like Crohns, for example. From what I understand, recurrence rates are pretty low for simple fistulas. More complex fistulas (very high ones and those associated with Crohns) can recur.
I really think you should contact your surgeon and ask some more questions so that you are comfortable with the decision you make. A core principle in medical ethics is "informed consent" - you must give your informed consent to a procedure, and that means you are entitled to ask questions.
Many of us have gone to our surgeons (or called them up) with a list of questions to ask, such as:
What does this surgery involve?
What are the possible complications?
What will happen if I don't have the surgery?
How many of these surgeries have you done?
How many complications have you had?
What are the options in case I have a complication?
What will the recovery involve and how long will it be?
Those are some of the questions I asked my surgeon and I felt a lot better about having the surgery after my questions were answered.
There are a few boardies here who have also had a fistulotomy, so hopefully they will chime in. Don't be afraid to ask your doc all kinds of questions. It's your body and you have a right to know what they want to do to it!

Wow, I can't add much to Hope's very helpful and accurate post, but I will say that I've had a low (superficial) fistula in 2008, and in june this year had a high fistula laid open. The surgery isn't pleasant, but it isn't as bad as what you think. I was in a real state before the first surgery - my husband had to literally coach me out of the car on the day of the surgery as I was crying so much and wouldn't get out the car!!
This time I didn't really panic as I knew what to expect, and it wasn't too bad.

WOW,
Im sitting here now, filling up with emotions because i now understand alot more and feel very proud to have support and information from others! you people are wonderful, ty so much.
Hope...you have explained alot and this has helped me to feel a sence of relief as i was so confussed and i think when you go down into the unknown the ground is a bit rocky and it messes with your head and your life, it affects your day to day routine and when you have children (i have 3) its very hard to explain to them why mummy is crying and why mummy has no idea what she is doing half the time (from the worry) but reading your post reply really helped me understand and made me feel alittle more at ease...ty so much x
Val....your added extra was very helpful as i think this is what i am most worried about, i heard that this could poss make you incontinent but wasnt sure how and now i understand but also feel alot calmer and not so nervous about it all...i think if i hadnt found this site i would have been the same as you on the day...i dont think i would have been able to go through with it...but im going to try my best.
I would like to do a run down of my time up to and after surgery to try and help others maybe...i know ive read some other peoples run downs and its helped me a little so if anyone could advise where i start that thread that would be good.
I cant thank you enough to the people on here...you do an amazing job and without you i may have eloped or gone into hiding lol
This is the first day since i was told i would have to have surgery that i have felt some sort of relief and gave a smile...ty ty ty

You're very welcome, Di! :D I'm so glad you're feeling better. This forum has saved my sanity so many times and the people here helped me feel hopeful and to smile again.
It must be really difficult going through all this with little ones to look after! That's an awful lot on your plate - it's no wonder you're stressed!
If you decide to have the surgery after all, you might want to start preparing for the recovery phase, so things will go as smoothly as possible. The first thing most of us do is find good stool softeners. Most of us here really like Miralax - or Movicol as it's called in the UK. Stool softeners are important because the painkillers you'll get after the surgery will be constipating. Some folks get a back-up bottle of Milk of Magnesia, just in case it takes a little bit more to get the BMs started. Pain meds and stool softeners really help make the first week after surgery easier!
I think it's a great idea to post your experience. It would definitely be helpful to people who visit this forum. I suggest that you post it under "Considering Surgery or Already Had It?". That seems to be the place people explore a lot when we're worrying about surgery. Your story will be a welcome addition.
Keep smiling, Di! The surgery is not too bad and soon you'll be healed and happy and not thinking about your butt anymore.