I would appreciate any advice from those with fistula experience as I am concerned about my situation.

I was diagnosed with an anterior fissure 2 years ago and 4 months ago I had LIS. The operation seemed to go OK, but I have been left with faecal leakage since the op, which I have been managing by irrigating my rectum after each bowel movement using a small enema bulb.

Recently I have been noticing increasing soreness in my anus, especially after sitting or walking. I put this down to the leakage at first, but over the past few days I have noticed that most of the soreness is coming from my perineum, about 1-2 cm directly above (towards my scrotum) from where my anterior fissure is located.

I had noticed this tender spot several months before, when examining the skin tag that has formed around the fissure.

I am getting increasingly worried that this could be some kind of fistula for several reasons and I was hoping that those with experience could offer me some insight and advice into whether this is likely.

The main reason I am concerned about this is that I can almost see a groove under the skin that seems to be in a direct line from where the fissure start at the anterior, disappearing under the skin tag and then emerging upwards towards the scrotum, ending where the perineum is at its most tender. It is a strange kind of tenderness - sometimes just touching the skin there causes pain, but there doesn't seem to be any obvious marks on the skin. Pushing on it doesn't cause any sharp kinds of pain, more of a dull, throbbing pain. Does this sound like it could be a fistula forming?

Also, when I am squirting water up there with a bulb syringe to clean my rectum after a BM, I get a strange feeling at the anterior, like the water is leaking out somewhere. Does this make any sense?

There are many other reasons that I think that it couldn't be a fistula - for example, I don't think I've ever had an abcess, there is a general soreness rather than real pain, there is no opening in the skin, I have had a similar tenderness there for at least 12 months.

It will be a long wait before I can get to see my CRS to find out his thoughts on this. Could anyone offer me any insight in the meantime. Does any of this sound like it could be a fistula or maybe one that is forming? Is it just something to do with the fissure - referred pain or something to do with the nerves down there? Does any of this match your experiences.

I would really appreciate any help. If anyone needs any clarification please let me know. Thanks in advance.

Hi worrier12345... Sorry to hear of ur troubles sounds like u have been through a rough patch ... I had a fistula that was caused by an abscess that was drained .... So I can only give some relation to what ur experiencing ... One thing u said that triggered my experience was when u cleanse with the bulb and feel the water run else where .. When I had my fistula and it would flare up and the exterior opening would try and heal trapping the discharge, I would apply pressure and I could feel the discharge squish around and then it would make its way back out my anus opening ... Kinda like backing up instead of flowing through ... Usually with a fisutla there is an exterior opening which seeps but they can be internal too ... I have read other people's stories on here that their problems started with a fissure and after surgery they got a fistula maybe look around and ask a few members .... Sorry I'm not much help with it .... But if u think something is going on trust ur gut .. Get checked ...my doc wasn't a colorectal specialist he was just a regular doc well he was the chief of surgery but not a specialist in that area ... I guess what I'm saying is if it gets too bad get checked at the local ER if need be ... All the best keep us updated :)