Anyone had successful anal fistula surgery

I'm 9 weeks post fistulatomy surgery and life has gone back to normal. No incontinence, no real problems at all. I am 95% healed. I still have a small wound, but the discharge is all but gone. I still take soaks 2x per day, mostly as a precaution since I want to make sure everything is clean as can be while I heal the rest of the way. I see my surgeon again in 3 weeks to make sure I am fully healed, but based on my progress I have complete confidence that this mess is behind me (hahahahah, sorry, it's been a long day). Tulip, I think I have seen you posting for a while now. Please don't let the fear consume you! This is a crappy situation, but you have to brave the surgery if you have a fistula, it's really not going to heal otherwise. The surgery wadn't that bad, I only missed a couple of days of work and if you follow doctors orders you can manage the pain and healing. I wish you the best, but please don't be afraid, just get it taken care of and put this experience behind you!!

For me the surgery was surprisingly painless. I only had a hollow ache for the first two days after surgery and then nothing at all for the remainder of the 12 weeks it took to heal. How well you handle it I think is based on a number of factors- general health (e.g. are you one of the roughly 90% of fistula patients that don't have any underlying disease), cleanliness, age, diet, and, of course, the skill of your surgeon. I feel very thankful to my surgeon that the worst part of my recovery was the worrying that it might come back...the pain itself was virtually nonexistent. The other annoying thing was washing the area down after every bowel movement (and since I was eating 35-40g of fiber per day at the time, that meant 2-3 poops per day).

I'm 1 month post-op and doing fairly well.  I apparently had the fistula over 10 years.  I thought it was an in-grown hair which wouldn't heal and flaired up about once every two months, resulting in me squeazing a little pus out.  Well, in December of 2016 the little pus turned into a large abcess which totally freaked me out.

I bypassed a general practitioner and went right to a colon surgeon.  He diagnosed me with an anal fistula.  My sugery was scheduled for the end of January.  In the mean time I went through 4 courses of anti-biotics to keep the infection at bay.

The morning of the surgery I also had an elective colonoscopy at the advise of the surgeon (I just turned 50 and never had one).  Because the fistula did not pass the sphincter, into the rectum the Dr. was able to lay the fistula open.

I was off work a week.  It was a week before I could sit for any time without a ring cushion.  It was fairly painful for about two days.  But after that I didn't have to take any pain medication.  It drained chunky white discharge for about three weeks.  After a month, I still have a little throbbing at time and some soreness.  No infection though.  I also have the urge to make a bowel movement, pretty much all the time.  I'm hoping that will subside with more healing time.

My issue began with what I thought was a hemorrhoid that kept bursting back in early February (it is now early April as I write this, so two months ago).  I began feeling a friction time sensation in my peri-anal area that I attributed to the way in which I was sitting since the lump made sitting properly quite uncomfortable.  I had also driven five hours.

Fast forward a few weeks later and the discomfort and flare ups were becoming unbearable.  I finally headed to the urgent care where I was diagnosed with an abscess.  The doctor there told me I would need surgery as that was too tender an area.  He referred me to a dermatologist. 

The dermatologist did the incision and drainage procedure and this helped relieve a lot of the pressure and discomfort but the blood and drainage continued, especially after a bowel movement.  Flare ups were reduced but still occurring. 

Urgent care had placed me on the wrong antibiotic, it was later determined after the dermatologist sent in the culture.  I had an e-Coli infection as opposed to a Staph infection, which I was told tends to be worse and resistent to many antibiotics.  I find it quite surprising that much of what I read on the Web suggests antibiotics are unnecessary when it comes to a peri-anal abscess.  This is clearly an infection and requires an antibiotic.  The correct antibiotic may have helped reduce the pus but by my third visit in just under two weeks the dermatologist felt the swelling and inflammation should have gone down completely by this time and sent me off to a rectal doctor and one more equipped to deal with a potential fistula.

I completely lucked out as the rectal doctor had an opening for that afternoon.  He determined that the abscess had not been drained completely and proceeded to make a much larger slit with the incision and drainage.  He also conducted a fistulotomy, not to be confused with the actual surgical procedure.  This was a simple probe to determine the existence of a fistula.  He told me it was a deep abscess and pressed to demonstrate the inner access point and the exterior access when the abscess had formed. At the time he noted a possible seton as the inflammation was too much to determine where the tunnel/channel crossed.  This was not considered a complex fistula from what I could tell.  This doctor happened to be my friend’s doctor and I was advised he had a very solid reputation.  Was very nice and confident.  Talked like he could do the procedure blind folded lol.

This was on Wednesday and my surgery was immediately scheduled for Monday. I was advised the surgery time would be from 9 am to 3 pm though the actual surgery would only take 15 to 30 minutes.  Following this last incision and drainage I barely noticed the affected area and went about my normal routine though there was still minor swelling, some bleeding and pus present.  Still, this was night and day compared to what I had previously been experiencing.

This would be my first surgery under anesthesia so was nervous going in and worried I might not be able to be put under (I do need sleep aids).  Anesthesiologist assured me in her seven years of doing this only one person every experienced an allergic reaction and they have protocol to deal with that situation. Everyone assured me I would be knocked out and sure enough the moment they began hooking me up to the IVs I was out cold. 

Next thing I remembered, it was about two hours later and the peri-anal area was sore and I woke up asking to use the bathroom.  They gave me a container and I was able to pee no problem. 

Within about 10 minutes I was brought off the bed and was able to sit (albeit wasn’t easy with the sore).  I also inquired about any seton placement and told there was no mention of it in the datebase, so good news there.  They gave me crackers and small containers of cranberry juice.  It was important they were not discharging me until I could demonstrate I was able to urinate more.  Once done with the juice I went into the bathroom and did just that.  The nurse was happy with the result and preparing me for release BUT it is important you have someone pick you up.

I had already notified my friend and he was already on his way as the surgery and recovery time had pretty much gone as scheduled, concluding at 3 pm.

You need someone to drive you home.  You have to be present at the pharmacy to get your pain killers as these are narcotics and the hospital cannot simply call in the prescription.  I went to the pharmacy, showed my ID and my friend drove me home and went back to pick up the pain killers.  I was nauseous and sore at this point (very uncomfortable sitting in the passenger seat).

Once home and once I finally received my pain killer, was admittedly in a pretty good mood having completed the surgery and feeling mostly soreness as opposed to actual pain.  The stomach issues resolved pretty quickly (it appeared that the morphine had caused the stomach issues, probably coupled with the anesthesia.  My rectal area was also tight and sore in addition to the external wound area, which seemed to have some type of plastic-feeling dressing.  Not sure what it was as I didn’t feel much like exploring the area. I didn’t sleep great that night due to the soreness in both regions.

Day 1 after the surgery, in addition to the soreness, the other main discomfort was my dry throat courtesy of the tubes I was told had been placed down my throat. 

By day’s end my whole body began to get sore.  This came on relatively slowly.  The surgical area on the outside was bleeding as expected but there was little in the way of anything other than red blood.

Day 2 after surgery my body was super sore all over to the point that I hardly paid any mind to the actual area that was operated on.  The Oxycodone helped over this period but made me quite sleepy.  On this day it was tough to get comfortable even laying down.

It was on this day that I also appeared to peel off whatever was covering the wound.  This was the first pain I felt per se once the wound was exposed and I was unable to touch the wound without registering the sharp pain, that I would describe as “moderate” and close to a 6 on the scale of 1 to 10.  It lasted no more than an hour with the exception of when I touched or rubbed against it.

Day 3 (Thursday) after the surgery my body soreness started to fade by the AM.

I hadn’t had a bowel movement yet and was worrying because inside my anus appeared to be stitched shut.  I could feel what I thought was stitches but they actually turned out to be part of a big bandage I yanked out of my rectum.  Had no idea it was in there.  Lots of bleeding followed as did a very solid BM that caused zero pain (to my surprise).  Take Metamucil and MiroLax as directed and keep in mind that the pain killers, while great, result in constipation.  Lack of BMs I believe are a result of the anesthesia and its associated side effects.  Despite the lack of cowel movements I did not feel constipated.  It shoiuld be noted that I was doing little eating to this point following the surgery.  Also, the bandage was causing the tightness inside my anal area. 

With the bandage pulled out, the bleeding and the rather significant bowel movement I had felt mild throbbing soreness in that area the remainder of the day. Constant sitz baths helped.   But I will say I slept like a baby this night with no serious soreness felt unless I happened to rub against the wound.

Day 4 (Friday) decided to take local drive to do some grocery shopping.  The wound area was still sore but really only when sitting or rubbing against it.  I was not very comfortable driving at this point but it was bearable.  This was due to the pressure placed upon the wound.  It was the first time sitting since the day of the surgery.  I had also cut the pain killers down to one this day and that was before bed. 

Day 5 (Saturday) went out for lunch and continued feeling better.  Again, it was just when I sat and applied the pressure that the wound area caused any discomfort.  Unlike when I had the abscess, the area did not experience continued inflammation. 

I am wearing the feminine wing pads and they are fantastic in dealing with this.  While I have the bleeding still, it’s leaving minimal stains on the pads compared to before.  I am leaving a piece of cotton in my rectal area as that continues to bleed as well.

I have had four BMs since this day with the last one an hour ago from when I was writing this.  The stools even passed over the open wound.  Really anticipated some type of flare up but nothing as of yet.  I immediately jump in the shower and the bath as it is important to keep the area clean.

I’m fortunate enough to work from home and have done so laying in bed and applying the least amount of pressure on the surgical area.  I will occasionally work while laying on my stomach.  I could not see myself venturing to an office job the first four days after surgery and certainly no jobs requiring strenuous activities.  By Day 5, I could probably have returned to work with some degree of confidence.  Just make sure to have an adequate amount of dressings and a pad in place.  I also like the thin cotton ovals to place along the wound area.

The healing process I know will likely take three months or more so I’m not gonna fool myself and believe there won’t be any setbacks.  The wound is wide open and about the size of a quarter.  It’s still bleeding with very little evidence of pus.

My follow up was scheduled for approximately 3.5 weeks after the surgery.