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Update on fistula and fistula questions

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Posted 1/9/2013 10:20 PM (GMT 0)
Went to the colon and rectal surgeon today and he looked at my anal area and rectum and said he didn't see any fistula he only noticed a narrowing of the sphincter, whatever that means. But other than that I have very healthy anal area. He was already taking his gloves off when I asked him if he could look at the vaginal area. He said okay and put another pair of gloves on and I showed him the small hole. He made that face doctors make when they see something wrong. And he agreed it is a fistula.
Is it weird that I was actually happy he saw it? After having the MRI results come back normal, and the GI not seeing it, I think people were thinking I was crazy! I have had fistulas before I know what they look like!
But he saw it and he said he wanted me to go into surgery so he can search more. That he may put a seton in. Do setons hurt? And what do you think is the recovery time for something like that? Or if he ends up doing the fistulotomy what would be the recovery time for that? I'm a college student and don't want to miss too many days but I also don't want to do something stupid.
Oh and I am on Humira weekly and azathioprine 2x a day have been for 2 years.
Posted 1/9/2013 10:34 PM (GMT 0)
haha, nope, not weird at all! I'm always happy when my concerns are validated. MRIs rarely see them. Suggest a barium test - they insert barium and then xray or something to see where it goes.

I have a rectovaginal fistula that has a draining seton on it. I would much rather have it than a fistulotomy. The seton hurt for about a week or so after it got put in, but now I barely notice it. Sometimes during sex if the angle's wrong or something it can push a little funny and hurt or if after the bathroom I wipe too hard or something.
Posted 1/10/2013 4:37 PM (GMT 0)
By surgery, I'm thinking he means an Exam Under Anesthesia? I had one done about 6 mos. ago to have my fistula(s) looked at and a draining seton put in. It was a one-day affair, I was put under general anesthesia and felt fine afterwards, although I needed a driver. I had it done on a Fri., and took the following Monday off, just in case, and was back to work on the following Tues. The seton took just a few days to get used to, but I wouldn't say it "hurt". It still does not hurt unless, like scifigal, I wipe it "wrong" or pull it in some other way, and even then, it's just a fleeting twinge most of the time.

So sorry you're going through all this - let us know how it all goes!
Posted 1/10/2013 7:11 PM (GMT 0)
Hey Lovely...glad you got a doc who listened. Putting in a seton is considered a surgery (mine was an OutPatient procedure) so he could be referring to that---or just getting a look may be a surgical code(can't rem what CPT code it falls under). I can't be sure about telling you about pain because, to quote the surgery nurse, "If you are going to have a fistula, you have it in the best place". Mine was perianal and had little muscle involvement. It is muscle involvement that usually causes the pain I was told. I was uncomfortable for a few days, then self conscious for about a week...then I hardly knew I had it and I never felt it come out. It was uncofmortable on the occasions when I had the loop shortened--but didn't last long either.
Still recommend sitz bath and hand held shower sprayer to avoid wiping as much as possible.
Posted 1/11/2013 3:34 AM (GMT 0)
I have had 6 fistula repairs in 4 years. When I had the Seton, it was never tightened. Then I went in for the reversal of the ileostomy, and the wrong area had been treated for over year. This is at Barnes Jewish Hospital, St. Louis. Supposedly, one of the best. I should have requested a second opinion. Please do that. They reversed my ilestomy on Thursday and put it back in on Monday.....
Posted 1/11/2013 4:35 PM (GMT 0)
I got the date for February 8th. The nurse told me they're going to do the flexible sigmoidoscopy and either a fistula plug or a seton. I put a separate post asking about the plug as I didn't see any of you mention it. From what you say it seems like the seton is the better option but the doctor didn't ask me what I wanted. I don't know if I should let him do what he thinks is best. Really scared, but I don't think this will hurt as much as the fistulotomy I had 2 years ago with the wet to dry dressings. at least I hope it doesn't hurt as much!
Posted 1/11/2013 9:27 PM (GMT 0)
The first time I had setons put in it hurt for a good 10 days after.  But I had a bad infection and he "cleaned it out" and put 3 setons in (2 through one fistula, 1 through another).  The second time I had a seton put in (after a failed FLAP procedure - well not complete failure, improved things about 50% my surgeon said) it only hurt for a few days after.  Once you get used to it you hardly know it's there.  Definitely take lots of sitz baths the first few days.  I've had mine in since July and barely notice it now.
Posted 1/11/2013 11:44 PM (GMT 0)
In my previous fistulas I had them cut open and They had to be filled with gauze by a nurse that came to by house and that was super painful. I also had a 1 inch hole and then 1/2 hole afterwards. That hurt a lot for about a month until the skin wasn't so raw. I still have 2 dents and scars where I had that surgery.

So does the seton or plug hurt less than that or more?
I take it by what you guys are saying the seton hurts less, right?

Post Edited (Lovely985) : 1/12/2013 12:52:22 AM (GMT-7)

Posted 1/12/2013 1:36 AM (GMT 0)
Oh, seton hurts MUCH less than that!
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