Help! Any ideas what this is?

I recently had a horseshoe seton placed for an intersphincteral fistula to drain an abscess. I went undiagnosed for almost 4 months and was in constant agony. During the 4 month period, I was in and out of doctors and had all kinds of issues with my butt. Mostly localized to my anus.

After surgery, I was doing well for about a week and then my anus just started hurting again. Back to my colo-rectal doc and she said I have a fissure, but that everything else looks good - draining properly, etc. Started putting cream on it (nitro and lidocaine). Saw my doc and she says my fissure is much better. Yet, my pain persists.

Throughout this whole process, I have developed something that feels like a large skin tag on my anus. It's on the abscess side and it's probably the size of a pea. When I put the cream on it hurts. When I was going through my issues, I could feel something very dense and small behind it, almost like an actual pea or bb. There's too much going on now to feel around down there. Every doc who has seen it goes "hmmmm" but doesn't acknowledge it other than to say it's interesting. I am certain it is the source of a lot of my pain. Basically, every time I poop it hurts for about a good hour after. Sitz baths provide temporary relief.

Any ideas? I go back in 10 days and I'm going to address it with her, but I currently have no clue.

Stevo it could be a secondary track or fistula extension forming a small abscess. It may be superficial (without an internal opening) connecting to your existing fistula.