One Month Post-Fistulotomy (28 year old gay man)

So far so good! Great decision

Have you had surgery for a Fistula and would like to share your success with others on the board who might be worrying about their surgery? This is the place, snd we would be happy to hear from you. Also, if you want to keep a Fistula diary, feel free to do so.

Return to Fistula Success Stories

One Month Post-Fistulotomy (28 year old gay man)

Postby mcintj1212 » 01 Jan 2017, 21:02

I am a 28-year-old gay man living in Toronto, Ontario. I found this website to be very helpful to look through when I was going through this whole process and so I thought it was important for me to write about my experiences. Also, I found there was very little discussion on these websites from the perspective of a gay man, which I think is important to have because one of my biggest fears was (and is) that I will not be able to have sex again after this fistulotomy.

I've had a history of small fissures and haemorrhoids since about February 2012 when I first developed a fissure using a sex toy. They come and go now and then, so I've been very careful over the last few years having sex. In August 2016 when I had sex with my partner, something felt like it ripped and I was bleeding. I went to bed and woke up in the middle of the night with full-body shivers (I had no control over my limbs which were almost comically moving around) and a heavy fever. I went into the Hospital and they diagnosed me with bacteremia (which we later figured out was caused by an infected abscess).

Shortly after the hospital visit, I felt a pea-sized lump just on the outside of my anus. I went to my family doctor who thought it was a hemorrhoid. I wasn't convinced as I had had hemorrhoids before and this felt a lot harder than a hemorrhoid. It was also regularly discharging and bleeding (only spotting). I asked my doctor for a referral to a specialist and he sent me to the Rudd Clinic in Toronto.

For anyone from Toronto, I would consider going elsewhere. First, I've had two experiences there and in both I felt that they were not comfortable with gay men, or at the very least not comfortable discussing concerns of a gay man. I also felt like they were dismissive of my questions/concerns. My doctor started trying to push a fistula probe through my fistula without warning or consent, which was extremely painful. I went to my family doctor and pushed for a referral to Dr. Burnstein at St. Michael's Hospital instead.

Dr. Burstein was fantastic. He took his time with me, answered all of my questions and was comfortable discussing my concerns about being able to have sex again. Essentially what he said is there are no guarantees, as the scar tissue can feel differently for different people. That being said, he correctly pointed out that I was probably unable to have sex with the fistula as is, so it can't get any worse. So I decided to go ahead with it.

I had my surgery on December 2, 2016 - just about a month ago. I did it under general anaesthetic and it lasted about 20 minutes. I woke up in the recovery room and was pretty out of it. I maybe had up to a 3/10 in terms of pain at this point - they were managing it well. It turns out my fistulotomy was fairly superficial, with the entrance and exit fairly close to the anus.

I was discharged home about 4 hours after surgery. My doctor told me that some people go back to work within a couple of days, but that some will take up to 2 weeks off. I didn't want to take a chance that I would set it back so I decided to take the full two weeks off (while just answering some e-mails here and there).

The day after the surgery I had to take out the packing gauze, etc and have a bath to clean it. I was told to have a bath 4 times a day and every time that I had a bowel movement. I used a mix of a sitz bath in the toilet and full baths - too much effort to do a full bath every time. The gauze came out fairly easily without much bleeding. The cut looked gross (it seriously looked like someone took a melon baller to my anus!), but it was not very painful.

I was on hydromorphone for pain, which I stopped taking after 48 hours because I was having some constipation. I was very nervous for my first poop, and probably ended up pushing too hard the first time I pooped at about 65 hours post-surgery because I mentally just needed to get past that first poop. Try not to rush it like I did, as it was a bit more painful than it had to be, but even then, it was only a 4/10. I would wipe with baby wipes after each bowel movement.
I was told that I didn't need any nursing care and didn't need to repack the gauze. It was recommended that I use menstrual pads in my underwear, mostly to protect my clothes from the bit of discharge and bleeding that was coming out. I used the Always light flow pads, which were mostly not a problem, though the sticky wings would sometimes catch on my thigh hair which was painful! More painful that the surgery site to be honest!

I didn't sit down for the first two weeks as I didn't want to put pressure on the area. I did a mix of lying down and standing (I set up a pseudo standing desk at my kitchen counter and played on my computer there). I also limited my walking in the first two weeks as I found that even walking 200 metres around the corner to get a coffee made the surgical site feel uncomfortable. Though I really limited my motion, I'm not sure it was necessary. It made me feel better that I was taking care of it and doing the best I could for my recovery, but I probably could have pushed myself more. I also could have probably pushed myself more if I had continued with the pain medication. Through this whole process, I never hit more than a 4/10 on the pain scale, and that was rare. I would say most of the time was a 1-2/10 or just discomfort and not pain.

My first time going out for a longer walk (30 minutes long) about 2 weeks post-surgery felt OK. When I got home, though, I had more bleeding than any other time for about 5-10 minutes. That never happened again after.
At the two week mark, I started walking around more and sitting for up to 2 hours. I was still trying to limit my sitting as much as possible. At the 3 week mark I saw the surgeon again. He said it was healing great and that I didn't have to see him again. He also encouraged me not to cancel my trip to Vancouver the next day (a 5-hour flight). He said it may be uncomfortable, but it would not set back my recovery at all or aggravate the surgical site. He just said to avoid hot tubs, etc and try to stand on the flight as much as possible. So I went out and spent 5 days over the holidays in Vancouver. The flight was uncomfortable, but I sat on one of those doughnuts and was probably up for 10 minutes every 30 minutes.

I'm now at the 4 week mark. I barely have any bleeding/discharge - just a small amount here or there. I'm having very regular bowel movements which generally aren't painful - sometimes a bit irritating but that's all. I still have a bath after every bowel movement, but my doctor said it wasn't strictly necessary anymore. He said the whole thing should heal up within another 6 weeks and that it is very rare for it to recur.

All in all, this was a very easy recovery despite my anxiety leading up to it. The pain was generally very low and it didn't take long for me to become mobile again. I'm now back at work full time and that is going well (though it's awkward carrying around baby wipes to the bathroom!).

I should also note that I think I had what was probably one of the simplest fistulotomies out there, so this may not be everyone's experience. But I know as I was researching I read some horror stories and freaked out that would be my experience. I wanted to let people know that the stories are not all bad. If anyone has any questions, feel free to get in touch.

I will update this thread at the two months mark and then keep people posted if I am able to successfully have sex again. My bet is I won't try for a year just to be absolutely safe.
Fibre Addict
Posts: 11
Topics: 1
Joined: 01 Jan 2017, 20:22
Has thanked: 0 time
Been thanked: 2 times
Gender: None specified

Re: One Month Post-Fistulotomy (28 year old gay man)

Postby LemonMan » 02 Jan 2017, 16:42

Hi MC,
That's a fantastic account, and not too dissimilar to my own experience. I had an abscess laid open, so not a fistulotomy as such, but wasn't far off it. I think you are on the home straight now. It's sometimes difficult to find a CRS who is understanding, so I'm glad you had a good experience with Mr Burstein. Good luck!

Best LemonMan
Aug 14: Anal Abscess diagnosed
Dec 15: Anterior Anal Fissure diagnosed
Jan 16: Anoheal - Thought was healed end of Jan
Apr 16: Anoheal - Thought was healed end of May
Sep 16: Fissure back. Started Anoheal again
May 17: Botox and banding - fingers crossed
User avatar
Posts: 162
Topics: 4
Joined: 18 Mar 2016, 06:52
Has thanked: 10 times
Been thanked: 17 times
Gender: Male

Re: One Month Post-Fistulotomy (28 year old gay man)

Postby Ryleighsmama » 25 Jan 2017, 21:15

Wow!! I must commend you for being proud of you and who you are. Thank you so much for sharing. I will be having a LIS on 1/27 and I'll have to admit I am somewhat concerned. Hang in there young man, don't let anyone try to make you feel less than!! You Rock.
Fibre Addict
Posts: 29
Joined: 07 Jan 2017, 09:47
Has thanked: 9 times
Been thanked: 0 time
Gender: None specified

Re: One Month Post-Fistulotomy (28 year old gay man)

Postby mcintj1212 » 03 Jan 2020, 17:53

I am coming back after receiving a couple of e-mails with questions on how it has gone the last three years. Surgery was December 2016 for a fistula requiring a fistulotomy.
When I wrote the first post, I was a month post-surgery and things were healing well. While the site essentially stopped hurting after that point, the surgical site wound itself had trouble healing. The surgeon recommended I wait and give it more time. At the three month mark, while I was having no pain, the wound still had not healed and there was still discharge. At that point, the surgeon started having me come in and he would burn the wound open with silver nitrate, in the hopes that it would then re-heal properly.
The silver nitrate was a lot scarier in my mind than it was in reality. Sure it burned, and it hurt, but it was not that bad. The worst part really was that it was uncomfortable to walk for the day after and my butt needed a bit more attention for cleaning, etc again so it was easier to work from home the day after.
This happened about 5-6 times as it was not wanting to heal. The surgeon didn't know why, but recommended we continue burning it to see if we can get it to fully heal to avoid the discharge. Finally, after the last time, it took about a month and it fully closed up with no more discharge.
I had one other issue about six months later where it felt uncomfortable again and I thought it had returned. I went to the surgeon, he examined, and it turned out it was just a hemorrhoid. Phew. Since then, no other pain or issues.
I'm now going to talk about the gay sex part of things - so if you're not looking for information on that stop here. But in the interest of openness and knowing there are other gay men out there worried about this same thing, I wanted to address it.
To be frank, I am a bottom. And I was scared that I would never be able to bottom again. I thought that this surgery was the end of it - or, if I was able to, it would be only with very small dicks and very cautiously.
I told myself I wouldn't even try having sex for at least a year after it fully healed. I wasn't that disciplined. But I probably waited about 6 months, which was a year after the surgery itself. It was a little uncomfortable at first, but I think most of it was in my head. I think I was scared, tense and not breathing, which made the whole experience a bit more difficult. But it worked. I was still very cautious and didn't have sex very often. Sometimes I felt a bit of pain which I thought was the scar tissue, but it was normally not a problem and it usually wasn't enough pain to stop me or think I was causing damage.
Then I started trying poppers for the first time during sex. Previously, I had always been against trying them. I used these during sex for about 3-4 months and I found that they made a HUGE difference. It loosened everything up perfectly. I was able to have more sex, harder, with bigger dicks - no problem.
After about 3-4 months I found that I just didn't need poppers as much to be comfortable down there. It was like my butt got used to it again and I didn't need the extra assistance. Since then, I have been regularly bottoming with guys of all sizes (including those of an XXL size) and had no issues. I've had no pain. I've had no recurring issues. I even got DPed once and it all went fine!
So for all those gay men who are worried that have your sphincter cut in a fistulotomy is the end of being able to bottom - that's not necessarily the case. In my case, it's now been 2 years with no issues and being able to regularly bottom. I will add that I find condoms irritate my ass more than before - it may be an issue with how it rubs the scar tissue - but without condoms has not caused any problems with the scar tissue.
I probably won't come onto this website again unless another issue arises, but I'm leaving my account open and it is linked to my email. If anyone has any questions or concerns, please do not hesitate to reach out. I hope everyone is doing well and is healing well!
Fibre Addict
Posts: 11
Topics: 1
Joined: 01 Jan 2017, 20:22
Has thanked: 0 time
Been thanked: 2 times
Gender: None specified

Return to Fistula Success Stories

Who is online

Users browsing this forum: No registered users and 1 guest