Hi all,

Earlier this year I had a battle with endometrial cancer and had hysterectomy March 30th. Immediately after the surgery, I developed abscess between my vagina and anus. It was pretty painful and got too big. They opened it June 29th to drain all the pus pockets (1.5 cm wound). I was doing pretty well but it just wouldn't close nor stop draining. I met with a colon-rectal surgeon last Thursday. She said that I have a fistula which was what I suspected. The fistulotomy was scheduled for last Monday. I wasn't prepared at all. Tuesday night, the dressing was removed revealing a huge hole! I did not expect a hole. She said she was going to cut a 3-inch wound. 3-inch-- I thought a hairline cut not a hole!

She is very nonchalant about the whole thing. She said that if I had a fistulotomy without a seton then I'll be fine the next day. And that I could go back to work the next day. I could go back to my workout routines which include swimming the next day if I felt up to it!?!?! Today is Thursday and I haven't been back to work. I am hurting all over down there. Today I had my first poop. My doctor's only post-op instruction is to keep it clean and dry. She said that it'll be all healed in 6-8 weeks. I asked her a few questions about how I could help it heal. She didn't address any of my questions and said I did not have to do anything special but to keep it clean and dry. I have an open, gaping hole down there and I'm not to do anything special!?! I'm reading online and learning about sitz baths, manuka honey, ointments, etc. I learned fast enough that gauze hurts and I'm wearing pads. What do I do?

I am just... in shock. I am going on a vacation next Wednesday. She said that I would be fine to go on that vacation. I'm struggling with sitting up... walking a long distance, etc. Now I'm about to get on a plane soon.

Advice? Help?

Thanks!

Hi there,

Welcome to the forum! Sorry to hear about your issues, but eventually it all turns out well, just some patience is needed.

'You'll be fine the next day' is actually too optimistic... It's not as bad as you may read from some of the stories online, but it takes some time to heal, so you'll need to be patient. For CRS these are minor surgeries and maybe that's why she's nonchalant about it. You are probably in pain, need painkillers, and can't sit, let alone work out. Usually work out is not advised for some weeks post-op. If you go swimming you'll need to clean the wound right after it to prevent infection.

I'd advise sitz-baths (I was advised by my CRS to do it right after bowel movements and 2-3 more times per day), they help the cleaning process, put some antiseptic in it, you don't want it to get infected, obviously it's the most sensitive area in that regard. If you'll be away from home, try doing sitzbaths too, though it may be difficult to arrange given the time schedule during holidays.

How long is your vacation? Just make sure you have regular check-ups with your CRS to see how the healing goes; one of the most important things is to prevent the wound to heal outside first, then it will get infected inside and another fistula can form. So actually don't try to make it heal faster. Did she schedule your next appointment?

Healing time is individual, in 6-8 weeks it can be done, but for some it takes longer. Yours is apparently simple and no seton, so shouldn't take that long.

Wish you the best! Let us know how it goes.

Thanks Garrod for your help!!!

I think I will hold off on the swimming part a bit longer. Sitz baths have been helpful so far- good tip on putting the antiseptic in. I have Hibiclens. I will be leaving Wednesday morning and returning Sunday evening. I could pack my sitz bath with me. And I could make sure I get back to the hotel to rest and do sitz baths regularly.

How do I prevent the wound from healing outside? What things would make it heal faster?

She didn't schedule my next appointment. I suppose I should call and schedule something two weeks after the surgery.

Thanks!

You're welcome, Naomi! Glad you're on the sitzbaths already :) I've heard people using epsom salt too as an antiseptic.

I have no advice no how to prevent it from healing outside first. It did happen to me, though not sure why. After my surgery I went to only one check-up 1 week post-op (if I remember well) and then travelled for several months with no visit to a doctor. Then things didn't heal well, and it went unnoticed until I saw my doctor several months after.
That's why it's important to have regular check-ups with your doctor, since they can see whether it heals properly. Maybe you could visit her once you're back from vacation?

After my second surgery I was worried about the healing, and while my doctor said nothing, I've read from some people here on the forum that they were advised to stretch the wound, it should prevent it from healing outside too soon. I never did it, not sure how to do it...

Have a good time on your vacation!

Thanks. My CRS doesn't seem to want to see me on a regular basis. Maybe I should work with a different doctor?

I do have yellowish pus that is coming out today. My surgery was last Monday. Is this normal or should I be concerned about any possibility of infection?

Yellowish discharge and blood is part of the healing process, it's normal, unless it starts to smell badly, then it may be a sign of an infection. But you'll have that discharge for some time after the surgery (there are a lot of posts on the healing process in the subforum Diaries and Success Stories, you'll see it's normal). For some it stops a week or two after, for others months after surgery, it depends.
If your fistula was simple, maybe your CRS is confident about the healing going well and doesn't think check-ups are necessary. I guess it's best to be followed by the same doctor, but if yours is not that responsive, I assume any other CRS can see if the wound is ok and there's no infection?

Hi Embracingthehole,

Welcome. My CRS was a bit nonchalant as well but as Garrod said and my doctor's nurse told me, these are pretty simple and routine operations for them. Though we certainly don't feel that way. ;-) Garrod has given you excellent info! I just would second the fact that your CRS may have felt is your fistula was simple that healing will go well and wouldn't warrant another visit. My surgeon was in another city about 2 hrs away and I was also moving cross country so they had me follow up with a primary care doctor and that was only to sign me off to go back to work which was required by my graduate school. Otherwise I think he would have just had me call had I developed a fever or green pus or other infection like symptoms.
Though I think she could have warned you about the hole. It is a bit of a surprise huh? I too expected they would stitch me up till I was told.
If you can pack your sitz bath definitely do. Even if you can fit in 10 mins in the morning and evening it will help. Warm water brings blood to the area and helps with the healing as well as helping to stay infection free. The water helps slough off old tissue as you heal and also helps clean after BM.

I hope you are going somewhere nice and enjoy yourself, you deserve it!

Thanks Garrod/ Manitourose...

I have to look for those diaries and success stories.

Yeah I would have liked to hear from my CRS that it's going to be a hole! :-) I am trying to get off pain medication. I have been taking it at bedtime the past two nights. It's hard because it still hurts during the day. I ESPECIALLY HATE when I need to pee and the urine burns! It's one of those rare times I WISHED I was a male! :-)

Thanks for the tip re: sitz bath. I will pack it. I have a big suitcase and it'll fit. :-) I do wonder about sitting in a hot tub- is that a good idea?

Being in a tub is okay too I have been told. I never had a sitz bath. Just drew a bath to a comfortable temperature and soaked for about 15-20 mins. I think whatever you are most comfortable with.

Hi all,

Almost 3 weeks later, I am improving nicely. However the end of the "hole" that ends at my anus is still open. What can I do to help it heal quickly?

Naomi