I am new to this forum and have a fistulotomy scheduled in august.

Saddly, I've had the fistula over a year ago but never given it much thought because a doctor told me it was a hemorroid.

I finally got the right diagnostic when i developed anal fissures post partum and seeked help from a CRS for the fissures.

According to CRS, my fissures are healing but the fistula will need to be operated. The operation itself involve just to cut a bit of the sphinctor ..so he said i might have difficulty to control gaz for the first week.

So my question would be : since my fistulotomy involve cutting the sphinctor a bit ... does that mean i am also having a LIS ?

Hi Yraine. Welcome to the forum. Sorry to hear you have suffered for so long but glad to hear you have surgery scheduled that will hopefully resolve things for you. I don't know that anyone would be able to answer your question. Even your surgeon probably won't know what he/she is dealing with until they get in there and see. That is how my surgery was. I had LIS and then a fistulotomy 4 months after (but it was superficial and did not involve the sphincter). Your procedure sounds like it may have a similar effect to an LIS, which would be good for your fissures anyway. Is your surgeon highly experienced with this type of surgery? Are you in a lot of pain now? Are you on antibiotics.

My CRS seemed highly experienced. He said he sees 2 to 3 abcess/fistula patients per day and he operates half of them. I do trust him because he was the only one who diagnosed the fistula right away . He used this fistula probbing device to see how far the tract went and if it was operable. Prior to that i saw a gastro ( did a coloscopy ) and saw a general surgeon who both told me that it was not a fistula and referred me to a dermatologist !!!! So when i got the right diagnostic ...i asked the CRS : are fistula that rare ??? your other collegues referred me to a dematologist !! imagine if i listenned to them !!
My CRS did not prescribe me antibiotics... he said my fistula is well established and whatever abcess i will get ..i will drain it.
I was painless for 2 weeks...but now i am in pain because i popped my anal fissure open again. I have been battling anal fissures for 4 months now ..... The CRS told me all my fissures are healed ..but i had diarrhea last week...and the burning and the pain is back. I bled a bit, so hopefully, it will heal again.

Good luck! The fistulotomy is fairly painless but it takes a long time to heal (mine was 14 weeks but it was fairly deep, but low enough for lay open). It has a very high success rate.

I had my fistulotomy done 2 days ago . My CRS added an xtra surgery day and was able to operate me.

Now the misery of healing begins: doing sitz bath while my newborn baby cry in his crib.

Day 1 post op : it went well ... only had 1 bowel movement ( ive been going twice since this fissure/fistula ordeal )

Day 2 post op (today) : had 3 bowel movements !!!! Gahhhh scratching the wallllllssss .... so not feeling so well . This is quite a long and draining proccess .. poop in sitz bath ...do another clean sitz bath ....clean off with shower head ....apply antibiotic cream. Then wondering if i'll ever be normal again.

Has anyone been advise to go in the sitz bath for it to be less painful ? Ive been doing it ... i find it horrible .... is no fun for the lady parts ! But i must admit ... is not painful ...pain is mostly afterwards...

Also , my wound looks yellowish ? Is that normal ?

Hi Yraine,

I am a male so I'm not sure if things would be similar, but I can offer my two cents on how my experience was. I had mine on January 7th and by mid-April I was 100% healed...you'll still feel weird scar tissue for a while after (even now I still feel weird when sitting for long periods) but its no problem. Of course, this all depends on how deep it was and how experienced your surgeon was.

Important note- I actually never took sitz baths, I sprayed my wound down with a shower head with warm (not hot) water on the LOW setting after every bowel movement (I also ONLY used unscented wet wipes...no regular toilet tissue). I never had any stool leak through the wound (as far as I know) and my drainage ceased after 2-3 days (even immediately post-surgery the drainage was very low). I never really had any pain, the main annoyance was having to shower after every bowel movement.

I'd say going 3 times per day so soon after surgery is a GOOD sign, as many people have problems with defecation after surgery. If you start having severe diarrhea it can be a sign of a problem though. Healthy BM's are between 1-3 times per day...some people go as many as 5 times and it is normal, so long as you have no cramps or diarrhea.

As for the wound looking yellow, that could just be drainage...but I would ask the surgeon at your follow up appointment...he/she did schedule a follow-up right? It's usually 1.5-2 weeks following the surgery. If you have any fever or severe pain you should contact him/her sooner.

I hope i will heal as fast as you :)
My follow up appointment is in 2 weeks.
Drainage wise: im always bleeding a bit during bowel movement and throughout the day, ill have pinkish discharge....

Cant say i am in pain ...more like a constant discomfort ? .....

Do you still have discomfort during bowel movement after you have healed ?

Yraine,

I never had any discomfort during bowel movements when I had the open wound, HOWEVER, once it gets close to closing (tighter) and for a few weeks after it fully healed I experienced occasional "pinching" during bowel movements. Eventually it went away.

No pain when u had the open wound ?? Wow.... i have a high pain tolerance (gave birth without epidural ), but this this is definately not a walk in the park either ....
Thx for sharing your experience ! It gives me hope that eventually i'll be all well again !

Perhaps I had a really good surgeon...not sure. Really the worst part for me was the worrying and anxiety/obsession over possible recurrence, etc. I had to go to a psychologist for behavioral therapy. The best advice I can give is this- if you are otherwise healthy, had a good fistulotomy and went to a CRS...the chance of it coming back again is extremely low. I learned to calm down and stop worrying. I still have occasional discomfort after hard BM's or long days sitting on the computer....but its normal. I mean, even when I had a shallow scar on my arm it still itches occasionally over 16 years later...to be honest I'm surprised there is really so little irritation given the size of the wound and location. If there is no discharge, extreme pain or a new abscess, then there is no need to worry :)