So, I had my fistulotomy back in September.

It has been over 9 months, and I still have drainage.

I saw my surgeon in the beginning of February, and he told me that it looked pretty good, and that if I have any problems, that I could come back, but he didn't have to see me anymore. The months prior to that, he told me that it wasn't looking good (I had about an inch deep incision, with the fistula being 3 inches in length) and that I might have to have another surgery. But in February, he said it looked good.

So, the only symptom I had was drainage, which I was told was the last to go. And since the surgeon said I was good, I believed him.

About a month after my last visit, I started having anal sex again (I am a gay male bottom, and it was very taxing on my partner that I couldn't have sex with him for six months). So we continued to have sex for March, April, and May, all the while, I still had drainage.

Then in the end of May, I felt like I had to have a BM. So I go to the bathroom, and when I go to wipe, there was only blood in the toilet and on the paper. The bleeding was so bad that it was running down my leg. And it was a lot of blood, that it freaked me out, so I called a nurseline to make sure I didn't have to go to the ER. She advised me that I should be okay.
I return to my surgeon a few days later, and he told me that it healed improperly (basically, a chronic wound). He said that he was going to have to do weekly silver nitrate treatments until it was healed, and if it isn't healed after a month, he was going to have to debride the area. He also said that I returned to sex too early.

The first silver nitrate treatment was one of the most painful experiences of my life. The subsequent treatments weren't as bad.

My question is there anyone here who has had a fistulotomy who also has anal sex, and if so, how long until you could start having sex again? I thought I was good after six months, but I guess I wasn't.
To be honest, I wish I wouldn't have had the surgery. The original fistula was bleeding, infected, and painful - but this is so much worse (worse pain, worse bleeding).

Any help would be greatly appreciated.

Hi totallycharged,

I don't have an answer to your question about anal sex, but like you, I started bleeding again after my first fistulotomy. I went back to my surgeon who said the fistula had been closed, but that it wasn't healing properly and prescribed a cream and sitz baths. That helped my pain for a little bit, but I would still get bright red blood and drainage, not to mention always feeling uncomfortable. I saw a different surgeon a few months later - an actual CRS - and after his exam, he told me my fistula had never healed. I had a second surgery (fistulectomy this time) and was completely healed in about two months.

If possible, it might be a good idea to get a second opinion from another surgeon. Maybe it is just a chronic wound, but you could also still have a fistula. I had to have three surgeries in total (abscess, fistulotomy, fistulectomy) and while healing from my final surgery was very painful for 2-3 weeks, being able to live normally again is worth it!

Hi totallycharged,

I'm a straight male so I don't have experience with receiving anal sex but I know most definitely you should have waited much longer, perhaps even months after it fully healed, to return to doing so. That is a delicate area that is made even more delicate after that sort of surgery. Also, abscesses (which are almost always the initial cause of a fistula) are caused by blocked/clogged anal glands (much like a pimples are caused by clogged pores in the skin, only infinite levels worse). I know it must have been taxing on your relationship, but your health should always come first. I have a fistuolotmy in early January and it took almost 14 weeks to fully heal, but I stopped having drainage a mere 5 days or so after surgery (the wound was quite deep, but there was just almost no drainage post-op). Also, a question for both you and heartofitall- did you guys/gals go to a CRS or a GP for your surgery? The CRS is absolutely the way to go, as the chance of recurrence and the chance of proper surgery is increased substantially. But, in short, I think you need to lay off the anal sex until it is fully healed and even then you should wait a few months for the tissue to regain some of its strength. I have a sort of "ridged" scar near my anus from the fistulotomy and if I press on it there is some mild aching, which is normal, but I would be terrified of sticking something in my anus even now (it reached full healing in April). Give it time, eventually things WILL get better, but they won't get better if you keep aggravating it.

I did see a CRS. And I didn't have sex for almost 30 weeks (6 months) after my surgery, and waited a whole month from when my surgeon told me that "it looked good," and that it seemed to be healing well.

I have to have another surgery on the 22nd of this month. The silver nitrate treatments weren't helping very much, so he said he would have to debride the area. Hopefully, it heals better this time.

No sex for a long while.. Do I have to wait a year?

Just wait until the wound is fully healed and closed, and then I would personally wait another month after just to let things strengthen a tad. Of course, your surgeon knows better than I do...you should ask him/her when it is okay to have anal sex again. Don't be to shy to ask, its very important and he/she is paid to answer those questions. And definitely take their advice seriously and do exactly what they say. I'm surprised it was still open after 6 months...do you have Crohn's or some other sort of condition that delays healing?

I don't think so.

A few years back I had colitis. I started bleeding from my bowels profusely and was in intense pain. I went to the ER where they did a CT scan and gave me some medications. They then referred me to a GI doc.

I had a colonoscopy a few days later, and they said my entire colon was inflamed (his exact words were that it looked like raw hamburger). He thought I had a ulcerative colitis, but the biopsy said it was bacterial.

I didn't have sex for over a year after that happened. In a lot of ways, I was too afraid to.

Hmmm...interesting. Well as long as you aren't having severe bowel pain or constant diarrhea/constipation I wouldn't worry about having anything more. Unfortunately, if I were you I would treat this issue similar to that and refrain from being the recipient of anal sex until everything is back to normal (which it WILL get back to normal, don't get discouraged or depressed). You can still have sex, you just are going to have to be the giver rather than recipient. I had sex the whole time I was healing, but I never had anything close to my anus in that time period. For the sake of your health (and future pleasant anal sex experience) you should give it a long rest, you definitely have to think about your future. I know it sucks, but it will get better, just hang in there.

Yeah.

I do vacillate between diarrhea and constipation. (I usually have to go the bathroom close to 4 or 5 times a day). I sometimes get abdominal cramps when I have to go, but nothing too bad or bothersome. One thing that has concerned me though is that I always have a lot of mucus in my stool (and sometimes when I go, all that comes out is mucus).

So there are definitely some issues.

Hmmm...well you definitely need to see a doctor specializing in bowel issues then, more than just a CRS...perhaps a proctologist or get another colonoscopy? Diet can work wonders as well- taking a supplement like Metamucil can help add bulk to your stools and keep them smooth (abscesses are caused by clogged anal glands from excessive loose stools over a long period or hard-pushing due to constipation over a long period). I noticed mixing turmeric powder with black pepper in water and drinking it really calms my bowels and reduces inflammation. Also, make sure to eat a healthy diet all together and, if you smoke, stop immediately as that will drastically impact healing rates...plus excessive alcohol consumption can also impact healing. Make sure to get plenty of sleep and drink plenty of water. Exercise is very important too. I know it may seem odd to recommend exercise in such a pained state, but it will help (if your surgeon says you are well enough to, ask him first).