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Anus or no anus?

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Posted 2/25/2013 11:00 PM (GMT 0)
I was just curious to everyone's post surgery issues whether their anus was removed or not. Seems like surgeons have their own ideas which way was best. My surgeon says he does not removed the anus because all it does it leave a wound. Also it's painful and he has seen more complication with it removed.

At least having my anus intact helps some of the fluid in the rectum area to drain out. I've had issues with abscesses mainly due to my body trying to adjust to surgery. Once my anus woke up and learned how to process the extra fluid out I've been fine. Post surgery issues were also due to a fistula in the lower part of my sm bowel...most likely due to surgical placement or removal of the abscess drain tube.

So please indicate whether you had you're anus removed and what type of surgery issues or non issues you experienced. Also how do you feel now?

Thanks for posting!
Posted 2/26/2013 3:26 AM (GMT 0)
P&H
I had my colectomy November 2007. I have my anus. I have not had any problems with the anus. For about 3 years I had occasional drainage. It tapered off and stopped. When I spoke with the surgeon (2007) there was little discussion. I was so sick I told him I did not want to talk about the surgery. I just wanted it done. I did not know there were options. He used his judgement and I am fine with what he did. I have read several times that people have real trouble with the anus removal not healing and have to use a wound vac. I can only guess what that is and how much fun it must be.


Dan
Posted 2/26/2013 4:40 AM (GMT 0)
I had my anus removed as that is what my surgeon prefers. Mine healed fine with no issues.
Posted 2/26/2013 4:53 PM (GMT 0)
I went from J pouch to end ileo. I did not want my anus removed when the J pouch was excised. My surgeon "normally" does remove it but he was very accommodating and so I have my anus. There was a post surgical abscess which responded to oral antibiotics I kind of doubt this was related to leaving the anus, but who knows? Once the abscess was treated the secretions (surgery was mid Dec 2012) have lessened to the point that they are not an issue. So thus far I am quite happy with my decision both for the end ileo and leaving the anus. I recovered quickly, it feels natural down there.
Posted 2/26/2013 9:01 PM (GMT 0)
I had my anus out and had a lot of problems, including needing another surgery to fix the wound, walking around for many months with an open wound, etc. I am not sure what I would decide if I had it to do over again, though.... if you leave the anus, there is a cancer risk there, and you need to get scoped for it. I don't like the idea of having mucous coming out, and it sounds like some people have that indefinitely.

I too was very sick and mostly going w/my surgeon's preference. I think the issues I had were related to how sick I was.... she was very upfront though that healing this wound would be the hardest part.

I did have an abscess after surgery, and my surgeon had to cut open some of my stitches to drain it. It's not clear whether that was part of the problem w/the wound not healing.
Posted 2/26/2013 9:28 PM (GMT 0)
My surgeon left my anus his idea was it helps support the pelvic floor and removing it causes to many complications , after the complications I had following surgery I'm glad he left it there couldn't imagine having to deal with some of the stuff mentioned as well
Lucky
Posted 2/27/2013 1:53 AM (GMT 0)
Removed at the time of my proctocolectomy. Really no option with the number of peri-anal fistulas I had...and didn't want to have! Packed it and it was fully healed about 2 months post op. Did have complications between 5 - 6 months post op (I expected to have issues during first year) with an abscess. Had it cleaned out, antibiotics, wound vac and more packing. Fully healed at about 9 months post op from proctocolectomy. No issues since.

Would do it all again...even with the complications.
Posted 2/27/2013 5:21 AM (GMT 0)
blueglass
Scoped for cancer when anus left?? Tell me about this. I am 5 1/2 years post surgery and have not seen the surgeon for 5 years. Don't plan to visit.

Dan
Posted 2/27/2013 7:52 AM (GMT 0)
I had mine removed, didn't like the risk of cancer and didn't want more surgery. Compared to others, my anus was sewn shut. The 2 weeks after surgery were very sore. But then the swelling goes down and the stitches dissolved, i was right as rain. No issues at all.
Posted 2/27/2013 10:02 PM (GMT 0)
Dan, one of the reasons my surgeon gave for removing the anus was that people don't go back to get scoped, and they need to. I believe she has seen some cases of anal cancer in people who had proctocolectomies with the anus left. Obviously it's not a very big scope kind of thing, but perhaps you should ask about it.

My gi was saying that the numbers for colorectal cancer w/people w/longterm IBD in the colon are given as around 30%, but he thought it likely that my risk was higher, given the amount of inflammation I'd had for the length of time I'd had it.... no idea how that translates when all you have left is the anus, but I didn't hear it as a trivial risk.

Like you, I was too sick to be in a very good decision making frame at the time of surgery, and I guess right now I don't really know if taking my anus out was a good choice or not.... and for me it's done, doesn't really matter. For someone who has time to make an informed decision, I would recommend finding studies, as there's so much than can go wrong w/these surgeries, so it's hard to tell from anecdotes....

It's also very possible that I heard/remembered things wrong, so I may not be quite right on the cancer issue.... but it does seem worth at least an email to a gi or surgeon....
Posted 2/28/2013 1:23 PM (GMT 0)
I just signed up to this site after seeing the "anus or no anus" post. I had colorectal ca 3 times over 7 years. Had radiation each time and finally had to have my rectum removed. I have had temp colostomies and would not have wanted to keep the anus after needing a permant colostomy. I had no choice anyway. I would not suggest anyone keeping a useless anus. Doctors come up with reasons to keep it, I feel that's due to the radical surgery required to remove it and replace with a flap of skin taken from elsewhere on the body. It's very risky keeping the patch from dying and wounds from the surgery that can possibly take months to heal. I was fortunate to have mine done at Cleveland Clinic in Weston South Florida. I have no complaints. Better off without an anus. While on temp colostomies I recall the discharge that happens at a moments notice and hated it. Kinda like pooping ur pants. Maybe others have better luck and ways of dealing with the problems of keeping the anus. As far as a pelvic floor? The skin flap with fat is replacing the anus - rectum thus creating an alternate floor. My in nerds adjusted just fine and settled into place. All I know is it is one crazy surgery that took 8 hours, followed by so much pain medication I had to be on a breathing machine for a week so my lungs didn't shut down. I was 41 at the time of surgery, I'm 46 now and doing okay since the surgery. Final words "what good is a leaky useless anus? Toss it while in surgery NOW !!". Good luck, Bobby B, South Florida USA.
Posted 3/3/2013 3:10 AM (GMT 0)
I had my rectum and anus removed as I have Crohn's and I had significant rectal involvement. I personally found the surgery very difficult, it was done when my ileostomy was done. It was left open to close from the inside out, it took 6 months to fully stop draining and close and honestly I still have significant pain in the area
Posted 3/3/2013 2:02 PM (GMT 0)
Jil0tt, glad ur healed. I agree, it is one hell of a radical surgery. Difficult is an understatement. Best of luck to you. I sincerely hope your pain fades and u live a happy and comfortable life.
Bobby
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