Muscle-sparing techniques for fistula?

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Muscle-sparing techniques for fistula?

Postby ttt2018 » 24 Feb 2019, 12:35

Does anyone have experience with muscle-sparing techniques that do not touch the sphincter for anal fistula? I know they are much less effective than fistulotomy, but it may be a way at least to buy time...

Thanks for any input if so.
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Re: Muscle-sparing techniques for fistula?

Postby ttt2018 » 09 Mar 2019, 12:44

More specifically, has anyone had one of the muscle-sparing techniques for a SUPERFICIAL fistula? I have been scheduled for a laying-open of an apparently very minor superficial fistula, but it still involves cutting the sphincter, which I'm not ready for. As I await my next appt, I was wondering if others have done this. Thanks.
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Re: Muscle-sparing techniques for fistula?

Postby fistulotomy1984 » 14 Mar 2019, 09:18

Why not just go for a simple fistulotomy? It’s my post op day 12 and I can see the end of the tunnel already. Everything will eventually be pain free in 14 days for simple low fistula, at least, for a lot of the people.
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Re: Muscle-sparing techniques for fistula?

Postby ttt2018 » 14 Mar 2019, 09:30

Thanks for your reply. This is terrifying to me due to incontinence concerns.

I'm 4 months out from a still unhealed fissurectomy (w/advancement flaps) after which I have had a leaky bum ever since. My sphincter was not touched during that surgery, which was why I chose it, and yet I'm still having issues, supposedly temporary but I do not see that as a guarantee.

Everywhere I read, incontinence risk factors for fistulotomy include previous anal surgery (check) and previous continence issues (currently, check). So... The doctors don't seem concerned but I sure am.
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Re: Muscle-sparing techniques for fistula?

Postby fistulotomy1984 » 14 Mar 2019, 09:34

Yikes, if it’s a second surgery, its better to be more cautious. Was it a low fistula before or a high complex one?
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Re: Muscle-sparing techniques for fistula?

Postby ttt2018 » 14 Mar 2019, 09:36

No, the previous surgery was for chronic anal fissure. This is my first fistula (immediately following abscess) due to long healing time.
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Re: Muscle-sparing techniques for fistula?

Postby fistulotomy1984 » 14 Mar 2019, 09:44

I had a fissure which led to an abscess as well. It seems a lot of abscess tend form fistula afterward. Was the opening of the fistula near the anus? If it’s near, it probably won’t touch so much of the muscle. But I can say I do get wind incontinence even with simple interspheteric fistulotomy.
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Re: Muscle-sparing techniques for fistula?

Postby fistulotomy1984 » 14 Mar 2019, 09:48

For me, I simply don’t believe in any homeopathy. The best is always get the surgery done ASAP so no further abscess would form and causes further complications. I can only say that for simple fistulotomy, it’s just like making a bigger fissure from the fistula and waiting for it to heal over time.
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Re: Muscle-sparing techniques for fistula?

Postby ttt2018 » 14 Mar 2019, 10:44

I appreciate your input. Have you only had the one fistulotomy, and it was a few weeks ago? Hopefully your gas problem goes away !

The muscle-sparing techniques are not exactly homeopathic, although they are much less invasive - and much less effective (about 50% success, it seems). And they might only be for deeper, non-superficial cases, which is why I asked.
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Re: Muscle-sparing techniques for fistula?

Postby fistulotomy1984 » 14 Mar 2019, 18:09

I had an incision and drainage of an abscess on jan 1st and opted for a fistulotomy once it’s form on March. I do believe everyone need to get at least two surgery to get it fixed once an abscess is formed. I can say today I woke up at post op day 13, there is only a tiny bit of drainage left but mine was a low interspheteic fistula. The gas problem is still there and I tend to need to get to the bathroom more often for now.

For those muscle sparing techniques or seton, it’s reserve for high fistula with low success rates anyways. The Indians are using these herb and thread to pass through the fistula. Its just looks too shabby and unscientific. Well, perhaps you could get a second opinion of another surgeon. It’s important to find one that’s gonna really take care of the internal opening and have sufficient debridement so no recurrence is gonna take place. I can’t stand another day of leakage and god damn gauze up my ass. It’s really unbearable as you may know. Hope you make up your mind soon and speedy recovery.
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