Adhesions causing pain even after multiple abscess/fistula has healed

Ok so since October of 2009 I have had three surgeries for abscesses and fistulas in the perianal area. The last one was five and a half inches deep (abscess) which protruded and adjoined to the back side of the soft penile tissue. The most recent MRI I had showed a fistula about the same length and possibly another fistula that butted up to my urethra. I have been in extreme constant pain lately and have been seeing a pain management doctor. I also have a ruptured disk that presses on the S1 nerve root. I still have an open lesion from the most recent abscess, but has closed in the area closest to the skin. I decided to get a second opinion since I have had so much trouble with this and provided this doctor with the most recent mri that was taken on March 31 2010. The doctor/colorectal surgeon didnt  even look at the mri, but instead poked at it with a probe and said based on what he saw from the outside that I didnt have anymore fistulas or pockets inside of me. This doctor told me that since he couldnt see anything from the outside that I must not have one and that I need to cease the pain medicine because I shouldnt be in pain. The funny thing is that all of these peri anal abscesses that I have had could not be viewed by looking at the area and could only be recognized with the previous MRI's. I will be going in for an updated MRI next Monday to see what progress I have made with the deep fistulas. The question I have is, would it be possible that I have adhesions deep inside of me that are still causing the pain, if for some reason the mri comes back clear? I saw this second opinion doctor only 2 weeks after the late march MRI so I highly doubt that these things have completely healed. Has anyone else faced this type of situation? I also can feel a hard knot like area that is next to my sphincter, so im not sure if this is somthing new or scar tissue.

Hi,

Yes, I think scar tissue can cause pain. Also, I have had exploratory surgery for fistula's and abcesses in the past that were on the MRI and they could not find them. I was told it is like finding a needle in a haystack. It is very frusterating and sometimes seems like an endless cycle. Keep on it the best you can.

Julia

Yes, I do think that adhesions cause a good amout of my pain. My mom even drug me around the world ( literally- from Texas to Germany) for adhesion removal surgery. I had tons of pain all over my belly- from way up high to way down low. The surgeon over there uses some special tool and adhesion spray and I have talked to tons of people who had great success after his surgery. It sounds crazy and it was super scary but I think it was worth it. I have a j-pouch and I had a huge fear he would somehow puncture it so I asked him not to remove adhesions in my lower abd area and just in the upper stomach. I don't have upper pain anymore. Now- it I could only be brave enough to allow him to do the lower stomach I might have much less pain then I do now... but I am scared!