Cutting Seton Experience

Hi everyone, hi Memmem.

Here again to report latest evolvements.

I had a very smooth surgery and I woke up to find that I had a cutting seton inserted. My CRS told me that I would not be able to see it as it is high in the sphincter, which proved out to be true!
I cannot see it, but I can feel it with my hand, so it's there...
I currently have no major pain (some stinging occassionaly). My CRS told me that it will not hurt (due to his magic tricks in the way he inserts it; typical Greek CRS bragging "I know best").

Now I must wait for around 20 days to a month for it to do its job and fall out.

If it doesn't fall out then I will go back to my CRS to cut it off.


I will update.

Hi Memmem, thanks man.
I'm now on the 6th day and no smooth sailing anymore, there is some major pain involved in the process .
Actually I have not been able to see the seton, it is inside. I don't wish to mess with the wound, so I just leave it there. I believe the CRS did a partial fistulotomy and left something like 20% of the fistula, which he encircled with the cutting seton.
I take some over the counter pain killers if its hurts a lot (mainly during a BM).
I talked to my CRS over the phone and he said that the first 10 days usually hurt more.
He also said that should it not fall off by itself, he will cut it in his office (around 30 days later).

Post Edited (Dimitri71) : 5/7/2018 3:33:42 AM (GMT-6)

Hi Dimitri,

I'm sorry to hear things haven't worked out for you in the latest round of surgery. From my understanding 8 days is a very short time for a cutting seton. I've always read that its weeks, if not a few months before they are supposed to cut their way through and fall out. The process is meant to be slow. Perhaps your specialist can clarify.

If you are back at square one then can I recommend the Advancement Flap? My specialist thinks that this is the most effective treatment for non chrons patients with complex fistula. I've had one already, that closed one opening, and it has stuck. My specialist has me going for an MRI and will possibly do another one on the other internal opening. Either that or a seton for a while. In any case, I don't think I've read you've had one yet and my experience with it was that it wasn't so bad. The recovery went well and the pain, while a bit of s truggle, was not the horror show I expected when reading up online about it.

Keep us up to date my friend and don't be too down. Something will work and will work soon. Just another step in the ongoing journey in getting rid of this thing once and for all!

Hi everyone,
I am pleased to report that things are going better for me. I am at 4 weeks post fistulotomy and cutting seton dropping off. Went to the CRS on Friday and he said progress is according to plan and expects the fistula to fully heal 100%.
Drainage is little (hardly any on the gauze after a full day).
Keep walking

Hi Quay, good to hear from you. Feels better so far, if I can, Lord willing, I'd rather not have them fistulae...In regards to continence, for sure nothing major like leakage. Maybe some urgency and a little -unpredictable- gas when I have to go to the restroom (in the morning). I am under the impression this is fading though and its early to fully assess. Very very minor change though overall, almost unnoticable.
Filac is good, check the VAAFT out as well. Nothing to lose really. Also LIFT is a good choice and zero risk. In case they fail, they all prepare the ground for fistulotomy.

Dimitri,

that sounds fantastic - really pleased for you. I've just made an appointment with my CRS to talk about VAAFT or FiLaC, so hopefully there's an end in sight.

All the best for the future. Hope it stays well.

Dimitri,happy to hear the good news!It`s really amazing to comeback to normal life after a long time isn`t it hahaa..Hope it stays the same man..

Last I reported in,I was panicking about little pus still collecting where the surgeon said its normal etc and then there was some pain in the area..I popped amox-clav for a week and flew back to turkey.

Well,he was right this time..It has been 3 months after the vaaft surgery,and I can say it is cured out.

I didn't take his word and went ahead to a profeessor radiologist who only does internal-anal ultrasound in istanbul.He said it is crystal clear,I can see more clearly with my machine than mri,no need for a mri..

Then the mri came up clean too..But turned out I had a bulging l5 disk which was causing glute pains near the anus and confusing me...Didn`t see that coming,but its nothing emergent like fistula/abscess thankfully..The radiologist said internal sphincter is fully intact and only there is some damage on the external sph.,but he was very confident to guarantee that it wont cause any incontinence come 20 years which was another big relief.

On that topic smtng to note,around 2 months after the last surgery I got back full flatulence control as well.Which wasn't as strong as before after the surgery.So don`t worry if you can not hold gas %100,the control and power increases.I was struggling to hold it when I was moving,now no problem,as strong as before.

Hope to hear more good news from you Dimitri!Stay strong.