FiLac Time...

Hi to all.
So yesterday I went to my CRS just to clarify things as progress seems to have stagnated.
Conclusions are the following:
- Main fistula has not healed yet (day 35).
- Secondary track has healed, secondary wound has closed.
- Fistula is now draining significantly less.

CRS also said most likely the primary track will not heal (if it does not fully heal within 20 days - an impossibility as I see it, he gave it a 50%-50%).
He also said the secondary track will not open again (he said 100% sure about this).

Action plan: Wait until January 25th when he can appraise the new fistula. My CRS has claimed from day 1 - as studies point out - that Filac helps the fistula become smaller or lower in about 50% of the cases. But he cannot tell yet whether this will be the case for me. Have to wait till January.
In case the fistula does indeed become smaller or lower, action around Feb. 2018 could be a new FiLac or Cutting Seton. He said that he does not believe that a new draining seton will be needed.
I am under the impression that he is not very fond of FLAP and does not know the LIFT.
So the options (depending on the type of fistula) will be FiLac or Cutting Seton (only if he is 100% sure that it will not threaten continence).
So how do I feel about the whole ordeal?
Obviously I am dissapointed to a large extent, yet things have improved, and that is somewhat of a consolation.
Patience is the name of the game. I'm going to have to wait....
Now in January, I will have to think again about whether to go for another FiLac/Cutting Seton or consider the possibility to switch to a new CRS and try the LIFT.
But there's time for that! I wish you all the best!

hi dimitri,

I went to follow up on 28 Nov, CRS said, need 2-3 months to know if Filac work or not.
My next follow up will be scheduled on 28 Jan 2018. action plan, if Filac fail, can perform Fistulotomy as my fistula is getting smaller and move to lower position. Pray hard to everyone.

Thanks for your message Jason, it's great to update eachother as this helps us go through this challenge. It is also helpful for others considering FiLac and in general going through this terrible ordeal.
Sending you my support.
I am still having drainage (less than prior to the surgery, but not as little as I would want to. It had decreased to almost nothing but increased to moderate amounts once again....).
I am on day 40 now, so no chance my fistula will be cured by FiLac this time...
I am meeting my CRS for follow up on the 25th of January (three months post surgery).
If possible I would like to go with something more aggressive, like Cutting Seton next time. I had a draining seton for three months and now Filac and months have gone by with no result really.
My fistula was mid-to high transphicteric so it was not possible to do cutting seton initially without continence issues. Like you Jason I am hoping and praying that the fistula will become smaller or lower through Filac, although my CRS told me he will not be in a position to judge this until the 25th of January. I look forward to your news and Karen's. Please keep us posted.
All the best to everyone and God Bless.

hi everyone,

I am on post 34 days after the Filac surgery, still minor light yellow discharge. It been on and off for fews hours stop and come back again..... the longer hours with no discharge is 9 hours..... not too sure this time the Filac will cure my fisutla.... another 3 weeks to know the result....

That's good news. glad you got a second opinion. Let us know what the final decision is.

Jasontch, agree 100%, family above everything, we need to push now, very tough, but certainly not the end of the world! It's curable. Fistuloctomy is ideal I agree, but not banking on it yet!

Hi nofistulas good to hear from you! how're you holding up with the seton Vs last time?

sounds good nofistulas. All of us are getting closer to killing the monster!! Patience and persistence...

Dimitri, so I guess your choice is to either stay with your original CRS and go FiLac again or to go to your new CRS and possible fistulotomy or FLAP?

Potentially,the Filac can fail again - although studies show that a repeat Filac has a higher chance of success. I guess there is no real downside of trying it again, right? The only obvious one being time. With every procedure and failure, it extends this misery longer. I know. I've been at this for almost two years now. In the beginning, my #1 priority was to preserve continence. Now having gone through this hell for over two years, i would rather just have this over with and have my life back.

I know it seems like you might have a tough choice, but it's good you sought out a second opinion. I think more people should do the same.

i was in a similar situation as you. my last appt, my surgeon told me that the fistula had migrated lower so i was a candidate for a possible fistulotomy. she wouldn't know until she got in there for sure. she thought it was superficial now and if so, she would just cut it out. if not, then LIFT #2. i had reservations as well with fistulotomy with a slight possibility of incontinence, but im so desperate to be done with this, i didn't really care anymore.

i had the surgery today. and it did indeed migrate lower and was superficial. so fistulotomy. normally i would be relieved, but i've had too many failures and have become quite jaded. i won't know for several weeks i suppose and i know better than to get my hopes up. so we'll see.

have you decided on whether to stick with your original CRS or go to the new one?

yeah, i think it's a good plan. you can always go to the new CRS if the second Filac fails. Plus you don't lose anything attempting it again.

you should consider yourself lucky that you have access to Filac. it's only recently available in the US now. If I had access to it, I probably would have tried it first as well.

Hey nofistulas and DBrookenz and thanks for your kind words. Good to read our progress through this board. We will all get over this. It's certain.
I was reading that in the US of A only, around 20.000 to 25.000 fistula surgeries are performed ever year!..Very few of them posting here..So we are a little bit more anxious or had slightly more difficult cases than the average fistula sufferer, but at least we are helping a lot of people by recording our sagas.
Nevertheless we ought to be optimistic just using statistics:
If a surgery has a success propability of 70% then 4 such surgeries lead to a success rate of 99.19%
If we consider a difficult case wth a 50% sucess rate:
- two surgeries have a success rate of 75%
- four would have a probability success of 93.75%.
All the best to everyone!!

Hi,
I want to share my experience with filac surgery I had it 2 weeks ago
The post surgery pain was mainly from the stitches inside anus where the opening trac, as the wound was bigger than expected but I didn't noted any pain from it rather than abssec for the last two weeks which was alot

Can any one describe any pain coming from the stitches inside? Specially after bathroom?

My Dr said that stitch will go down within 3 to 4 weeks from the surgery, but Im not feeling comfortable about it