Well, crap (re: abscess)

So I guess I spoke too soon regarding my abscess healing nicely.  On Monday morning, I noticed that I had a "pus pocket" over the incision site.  We were in Michigan visiting family, and I figured that it was better to get the pus out over leaving it in, so I sterilized a needle and lanced it myself.  It didn't hurt at all...the only reason I knew I had the pus pocked is because I checked it out in a mirror to see how it was healing.

I called the surgeon's office, and they called me in a script for bactrim and scheduled an appointment for today.

Fast forward to this morning, when I was looking at things in the mirror.  I noticed a pus pocket had formed once again, so I pressed around on the site (again, no to little pain).  When I did, some fluid came out of both my vagina and rectum.  Yikes.  I immediately suspected a rectovaginal fistula.  Great.

At my appointment this afternoon, the surgeon did a digital exam and said she thinks she felt something, and that the wall between my rectum and vagina seems thin. 

So, I now have an appointment with a colorectal surgeon in Rochester on Monday afternoon.

As to what caused this, who knows if the perianal abscess caused it, OR, if this developed as a result from the bartholin gland abscess I had about two years ago.  Ever since that, I've had pain in the perineal area that comes and goes, and sex is uncomfortable at times.  I read that both of these are symptoms of rectovaginal fistulas, and that women don't always notice drainage of fecal matter through the vagina. 

Ugh.  So now I'm worried about what the treatment is going to be, if I'll have surgery, what all will go on with that, etc, etc, etc. 

Eva Lou, why have you not had your fistula fixed?  Is it because your UC isn't really under control? 

And of course, this has brought the concern that I have CD instead of UC back into my head.  But, the surgeon reminded me that fistulas are a quite common complication of perianal abscesses, even in completely healthy people. 

what an awful post! I'm so sorry... Such a drag, I swear my abscesses & the resulting fistula have caused me more mental anguish than any UC accident or indignity. Well- re. not fixing the fistula- I've met with 2 colorectal surgeons, both of who are highly recommended, impeccable credentials, head of dept's at top-notch hospitals, etc. Both told me that the success rate for fixing an RV fistula is somewhere in the 30% range- low!!!! And that they wouldn't even attempt it on someone with any sort of active inflammation, as the grafting necessary to fix them won't "take" on inflamed tissue. I've had ongoing chronic inflammation for years. If they use a plug, very often the plug falls out. If they try to lay open the fistula tract & let it heal from the outside, the skin won't heal properly due to the inflammation. When you browse the Crohns board about fistula repair, the posts are pretty discouraging. My biggest issue with it is that it prevents me from being a j-pouch candidate- the stool would come thru the fistula. Maybe after the pouch is working fine & the inflammation is gone, they could try to repair it. But then you run into numerous surgeries on already compromised tissue.... It's a no win situation, for me. The fistula doesn't cause me much issues- when my UC is really active, I do get drainage thru it. But I wear a panty liner 24/7 anyway, due to "accidents". And surgery itself is not something I want to do over & over- first you need a consult with the surgeon, then a highly specialized pelvic ultrasound, then the surgery, then the follow-ups... it just seemed like a lot to undergo, when the success rate is so low even in the best of circumstances. Supposedly, the bioloigcs are good at helping them to heal. So that's my sad sack story! I wonder if mine wasn't related to the episiotomy during childbirth- it's basically exactly where they made the cut! Please, let us know how the surgeon appt. goes- I'll be very interested to hear what your surgeon says. Good luck- try not to get too down!

yeah, I forgot about the whole snipping near the sphincter part!!! Another unpleasantry. Not sure about that 30% stat- honestly, it was 2 years ago when I last met with a surgeon. I believe it also has something to do with why the fistula formed in the first place- obstetrical trauma, cancer, IBD, etc. That's partly why I'm so interested in your upcoming visit! Also read about them on the Crohns forum, there are tons of ppl. who've had that procedure done, with varying success rates. I have little luck searching for clear stats on the repairs- there's not too much out there that isn't a surgical "how-to" guide. Check this out, good read even though it's aimed towards Crohns- http://www.wjgnet.com/1007-9327/pdf/v17/i8/963.pdf   Another thing that may SHOCK you- both surgeons told me that the presence of a fistula indicates Crohns to a surgeon- that's why a j-pouch is out also. Now, my GI swears I have UC, I think I have UC.... but to a surgeon? I may have Crohns, thanks to the fistula. Sigh.... it only gets more complicated, eh???

I have basic knowledge of this issue, but I have to say this after reading your posts.

FG and Eva, you two have horrible luck when it comes with fistulas and abscesses. We all need some luck somewhere, you two just can't seem to find it.

I truly hope you two find a solution soon.

Rats! Sorry that you got this complication, FG. (Good thing you took some vacation before you found it.) I hope you'll be able to close it up-- if it's an RV fistula after all. I'm trying to recall what Pam222 posted-- because she got a fistula during her j-pouch procedures in 2009-10. Good luck at your appointment next week! / Old Hat (30 yrs with left-sided UC; presently in remission taking brandname Colazal)

I was dignosed April 6 2011 and on May 19 had a HUGE abecess drained. I am still having flare ups at the signt of the drain. It makes me feel better to know others are dealing with this too. Not that I am happy y'all have the discomfort i am having. I thought I was the only one out there dealing with this. what are some ideas yall may have yall use when its really bothering you: