Fistula plug -- Has it worked for you?

Hello all.  I am considering trying the plug for my peri-rectal fistula and am wondering if any of you have tried it.  I would be very interested in learning about your experiences!

My colo-rectal surgeon told me I have 3 options:

1) Do nothing.  He said there is no harm in leaving the seton in (it doesn't bother me). I could always try the other options at any time.

2) Try the plug.  My surgeon said the plug has a 40 - 50 % success rate in CD people but can be tried several times.  He said the procedure is minimally invasive (no incisions -- just a stitch or two to keep it in place).  He said I would need to be in flat bed for 3 weeks -- no sitting or walking (except for going to the bathroom) -- in order to give my body the best chance to grow into the plug.

3) Advancement flap surgery.   He said has a 70 - 80 % success rate in CD people.  He says my fistula is too high for any other surgical option.  Just as with the plug, he said 3 weeks flat in bed.

He recommended the plug before going for the advancement flap because the plug involves no cutting.  He said if it was him, he would try the plug several times before considering the advancement flap.

What has been your experience?  Does the information my surgeon gave me match what you have been told?

Thanks in advance for your response!

Thanks, Upt0106. I am glad your fistula is behaving well for you! I had such a horrible abcess that the entire area became inflamed with cellulitus. It nearly killed me, so I think I would keep the seton just to make sure it doesn't clog. But it is great to hear that someone else is having success! Thanks again for responding.

WOW! Five setons at once! I am glad I can't compete with that! My lonely one is a fashionable red. And I would very much like to keep it very, very lonely! If you get anymore information about the plug, I'd appreciate it if you would share it with me/us!

Hi Grouchygut1. Thanks for your insights! I am sorry to hear that you got bad advice from a general surgeon. I too went to a general surgeon at first -- he had no clue what he was doing or what the problem was. I was too sick and too green to even ask questions. After nearly dying, I got in with Drs who have many years of experience with CD.

My colo-rectal surgoen says my fistula is narrow. And it is a peri-rectal not a recto-vaginal like yours.
Clarification -- did your colo-rectal surgeon say that the plug never works for recto-vaginal fistulas or for fistulas in general?

Thanks again!

it seems you are all women, I commend you all for dealing with this dreaded aspect of Crohn's.

I myself am a guy, so it's a bit different for me, since I can't get a recto-vaginal fistula. Since my body couldn't give me one of those, it decided to attach a fistula or two to my scrotum, leaving me very unconfortable at times, like today, which is why I am on the board right now. Posting and reading here is one of the few things I can do when the frustration is so bad and the isolation of this disease kicks in from these kinds of syptoms that just won't seem to ever go away for good.

I had surgery and got an ileostomy back in April of 07 (i can say back in 07 now!) with the idea that it would give my lower end time to heal and the fistulas a chance to get a break from the constant irritation that comes with regular digestion. IT worked amazingly at first, but now the fistulas seem to drain just as much as before and are just as uncomfortable some days and I really don't know how I cope sometimes. I guess I have been living with it all for almost 15 years now, so I don't really know there is any other way.


I have heard about the plug, in fact my surgeon is one of the pioneers of that treatment out of Cedars-sinai, but the idea seems like a waste of time to me. Just how i feel at the moment.


I am almost convinced that the next appt I have with the colo-rectal surgeon, I am gonna ask for the full recto-colectomy and have em' close me up for good on that end. will that bring relief? i pray at night and in the bathroom during the day. I am sure you have all given similar prayers form the porcelain throne.

anyway, I wanted to say I understand your pain ladies and i guess I ended up whining more than I meant to.

Talk to you all soon.

p.s.: i think mine are orange. i don't look that often anymore either....it's too scary

Thanks everyone for your responses! I think my colo-rectal surgeon may have said it right -- the plug is worth a shot but don't be dissapointed if it doesn't take.

Unfortunately, my fistula is too high for a fistulotomy so it is the larger surgery (advancement flap), the plug, or live with my "close companion". Considering how bad an infection I had, I don't want to risk living with an open fistula. I just don't trust it to behave well and not clog.

At first I had a temporary seton put in first and it was a very attractive blue. The one I have now is fire-engine red. Maybe we should start a fashion line of setons -- stripped, spotted, festive designer colors..... One for every occassion!! But who would model them??

Glad Bag -- keep praying at all times! Tell him everything and ask for strength, peace, and guidance.
"4 Rejoice in the Lord always. I will say it again: Rejoice! 5 Let your gentleness be evident to all. The Lord is near. 6 Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. 7 And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus." (Philippians 4)

"10 So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand." (Isaiah 41)

Ladies!! How were all your RV fistulas diagnosed? I am a human ping pong ball at the moment. The GI hasn't done a pelvic since med school and wanted to send me to a gyno... as soon as I mentioned crohn and possible fistula she did not feel competent to look for one. Both referred me to a colo-rectal surgeon who said that I need too see a gyno for dianosis. I am calling the CCFA to see if they know a crohns competent gyno or a gyno competent GI. What do you all have?

ok, i was in a pretty worn-down mood last night when I posted here. I think i am better today, at least I am telling myself that.

thanks for the prayers Fallcolors, that was a nice gesture and suited me well this morning!

Fitzyk23 - when I got my rv fistula I had no idea what was going on I thought it was a girly thing and made an appointment with my Gyno and she was the one that told me it was a issue with my crohn's and quite honestly my GI really didn't diagnose it either he kept telling me to go back to the gyno, finally he sent me to a surgeon because it was an abcess at that point and had to be lanced - good times!!! He was the one who told me it was a fistula. It would never stay open and draining so I was visiting the surgeon quite often - the only thing that ended up fixing it was the remicade . I am surprised that the colo-rectal surgeon told you to see your gyno they really don't have anything to do with it at least mine didn't. Is it draining or is it an abcess? Almost easier to be an abcess so the surgeon has to see you. Good luck with it - so frustrating when people don't listen

I feel like the oddball...my seton is Green! I recently went to my OBGYN because I was not happy with all the answers I was getting from my other doctors regarding this fistula. My Colo wants me to start remicade and put the plug in. She also told me that I should not risk getting pregnant while on Remicade. I did not like that answers so I went and sat down with my OB and told him what I felt. We both came to the decision that I should do nothing about the plug right now because I am not in any pain from it. I am going to hold off and try to get pregnant and then maybe see what I do about the fistula. My fistula was a nightmare for me when I was in a constant flare for about 6 months. Once I got my tummy under control (Thank God), I don't even remember I have one half the time. If it bothers me again for a while then I think i'll go and see what I can do but I am content right now not being on extra meds and restrictions. This is just my story and I know, unfortunately, that I am one of the few lucky ones. Hope you feel better soon!

oh man..mine is red..i don't think i could lie flat anywhere for three weeks..not with 2 kids..

My issuses with a perianal abcess which had to be operated on 4 times now, has turned into 2 fistulas.  I have had the fistulas banded Nov 2011 and have had 2 follow up appt with the surgeon for him to retie the bands as they had come untied. My last appt was this past Thurs Feb 16th in which he had to retie the bands incside the incisions.  It is now Sunday and I awoke to go to the toilet and the bands had fallen out. The were still looped and tied so this means the went through the fistulas.  I had extreme pain from Thurs til Sun.   Is this normal for them to fall out???  According to my surgeon I was to see him again in 6 weeks to have them tightened.  

Hi, I'm new here.

Got my unwanted episiotomy and whilst being stitched up received a 'prick' that appears to have given me the straight,hairline RVF that I've lived with since birth of son in 2008. The suspected perpetrator stated I got the RVF through 'pushing in labour' I did have a long labour but the RVF channel is straight and not a wavy line like most RVF's I've seen xrays of. Her husband kindly pushed my son out by pressing hard upon my stomach/top of belly to 'encourage' baby out whilst she cut me and got ready to catch during one of the two contractions that I was in her birthing centre for.And I didn't appreciate the stirrups and lying on the back either. That was in Greece  . Since then I've waited for it to heal itself and got pregnant again, just recently giving birth to twins in the UK (great experience). Anyhow -

 Three UK consultants checked the RVF and stated they suspect it occurred during stitch up.

I read on the web about BioDesign Plugs for RVF and the like, made by COOKMedical. After a few years I hope by now they have had good results from operations done a couple of years ago and that I won't be their first guinea pig. Apparently over 70 Health Authorities have agreed to trial the plugs for a particular remedial surgery, sadly not RVF's. 'FIAT' trial.

My current consultant, who even goes to Guana three times a year to perfom remedial work on obstetric RVF's has only offered me invasive surgery. I have just spoke with him at a private appointment, although I am booked in with the NHS to see him on the 23rd May 2012. We are in agreement to scour the locality here to find a surgeon who will perform surgery with a plug. At least I have options.

I'll keep you posted, but it really is my wish to have this hairline nuisance plugged up for good asap.