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Crohn's Disease
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Posted 7/2/2009 2:21 AM (GMT 0)
My seton was put in last June.  I am doing much better on a large dose of Remicade, but am reluctant to have it taken out (my gi is fully supportive of keeping it in for now).  I am worried that if I have it removed, I'll be back to an abscess again.

For those who have had them longer than a year, how long did yours last?  Did you have it replaced?  If so, how did you know it was time to change it out? 

Thanks!

Posted 7/2/2009 3:09 AM (GMT 0)
They had placed two setons on me, one lasted about one month and the other one lasted about 4 to 5 months and then fell away. Surgeon placing the seton said that once the fistula heals, the seton should fall away automatically. This was about 7 years ago. Now they place the seton only if you have a fistula, especially perianal fistula. It did the trick for me, I never went on Remicade. But, I might go on Remicade soon...
Posted 7/2/2009 5:54 AM (GMT 0)
I had two setons inserted and then when they didn’t do their job adequately and the abscess kept spreading, I had a mushroom drain inserted.   I think it depends on the ‘type’ of seton you have inserted and the job it is in there ‘to do’. I had one which was a ‘cutting’ seton, which ‘laid open’ the piece of skin between my bottom and the abscess….. Once this skin was laid open it could heal properly….. it was taken out when my mushroom drain was inserted (after being in for about a month)   The 2 nd seton is still in there, and my surgeon has told me it will come out eventually, but I am currently waiting for remicade and applying for it – so after a couple of treatments he said it will be taken out and we will see what happens. My 2 nd seton goes into my tailbone and around through into my bottom, I didn’t even know I had a fistula there, but apparently so. I was only aware of the abscess – not the 2 nd fistula.   Hopefully it all works out for the best. I can understand you’re reluctance to have it removed if it’s doing tis job perfectly well at the moment
Posted 7/2/2009 7:12 AM (GMT 0)
My setons are replaced every 6-9 months or so. The surgeons are thinking about eventually removing the seton and plugging the fistula with pig tissue. We'll see what happens.
Posted 7/2/2009 11:14 AM (GMT 0)
My fistula starts high up in the rectum and a fistulectomy or a cutting seton would cut too much sphincter muscle (leaving me incontinent). I am allergic to Remicade and Humira, and Flagyl gives me peripheral neuropathy -- all the drugs that are good at shrinking fistulae. The only option I have to get rid of the fistula is the advancement flap surgery, but the success rate in CD is only 70-80%. I don't like the odds considering that if it doesn't work, I will likely abscess. I hate abscesses!

So my setons are here to stay. My setons have been in for over a year. If one becomes untied and falls out, then I will have it replaced.
Posted 7/2/2009 5:33 PM (GMT 0)
My seton will be 4 ys old in September. I have absolutely no plans of taking it out. I'm very prone to fistulas. I have been on remicade the whole time and when I have to delay it, it is a for sure thing that I will get another fistula. If it does ever end up falling out, I will play the seton lottery and see if it will close with no problems. If it doesn't then another one will go back in. I love mine...have not had an abscess since, and it causes no pain. The only minor inconvience is the drainage, but that is easy to manage.
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