Fistulotomy with Seton

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New Member

Date Joined Sep 2011
Total Posts : 10
   Posted 9/13/2011 11:50 AM (GMT -7)   
I have read a lot of postings on the Fistulotomy procedure and recovery, and I am truly grateful for all of the information. While some of the information did not pertain to me, most of it did, and was VERY helpful. So I really wanted to say thank you to everyone who has posted on this topic.
I hope that by posting my experience, more people will gain knowledge and maybe some of you can post with current updates about your recovery. :-)
In January of 2008 I was diagnosed with a fissure. It was extremely painful and took about 3 months of sitz baths, witch hazel wipes, and anti itch creams to clear it up. I never thought anymore of this pain, once it had healed.
Then in February of 2010 I felt a lump on the bottom right buttock, close to where your bum curls under. It wasn't painful, or squishy. Just a golfball sized, hard lump. When I finally got the nerve to see my Family Doctor about the lump it was August of 2010. He did not know what it was, and refered me to a specialist/surgeon. When I went to see him in September, he thought it was a cyst, and did not want to do surgery back there, unless absolutely necessary. So we left it at that.
In November of 2010 I had a LOT of pain back there. Then one evening it burst. A smelly brownish discharge oozed from this tiny little hole. I thought great! No more pain, and no more lump bothering me any more. I thought it would ooze for about a week, (like a boil) but that was not the case. I didn't worry to much about it because it only oozed on occasion, and really never gave me any upset.
Then it May of 2011, the hole sealed up; the absess tried to start again, and I was in extreme pain, I couldn't wear pants, sit, or stand for long periods. So I called the specialist/surgeon again. This is when he told me it was a Fistula, and that it required surgery. When he explained what would happen I almost fainted. How can you leave a gaping wound open in that area?
Within 2 weeks they called for me to have surgery, however we were heading into a busy season at work, and I was covering for a co worker, I could not get the original time off of work. They wanted to operate at the end of July, but my son was going into Lacrosse provincials and I did not want to miss that. So I postponed it again. And really started research the procedure. 
Friday September 2, 2011 I had a fistulotomy with Seton, (no more excuses) Preformed as a day surgery at our local hospital. I guess I am one of the lucky ones. The surgery went off without a hitch. I came out of the Anaesthetic and was a little uncomfortable. Was able to get up and go to the bathroom, and was home in about 5hrs. I slept most of the remainder of that day.
Day 1 post op. I was a little uncomfortable getting around (on a scale of 1-10 - maybe 4 or 5) light meals, lots of water, and pain medicine. Sitz baths x2 daily, and after a bowel movement. The wound is open and oozing pinkish-white, panty liners placed in underwear was catching all of the ooze.
Day 2 post op. Pain was worse (5-6 on scale) but it felt more like muscle pain than sharp pain. Was able to pass wind with no pain. Same diet (light meals, lots of water, pain meds) and I had my first BM. I had been dreading it. But surprisingly it wasnt bad. Cleaned up with flushable wipes, had a sitz bath. Felt better after that.
Day 3-5 post op. Walking around without much pain - more sore than anything. Back on a regular diet, bowels moved very easily... feeling better each day...
Day 5 post op - All is going well, until I went to for my 1st post op appointment. I guess with him looking at the incision site,and seton, it stirred it up a bit, more oozing and a bit more pain.
Day 7 post op - felt great! Diet back on track, 1-2 regular BM a day, pain at about a 1-2, down to 1 panty liner for the little bit of ooze. I thought I could go to work (I have a sit down office job) I made it from 9-3, then I had to go home. Pain medicine and sleep. But happy that I was able to make it as long as I did.
Day 8-9 - feeling good, almost back to normal. incision still open and oozing (but not nearly as much as when it was a draining fistula) still doing sitz baths 2-3 times a day. Able to sit long periods of time. Sometimes Seton Stitch gets in the way but all in all feeling good about the whole thing.
Day 10-11 - back to work now. Not a lot of pain or ache, ooze is almost down to nothing. Took a percacet last night for some pain after sitting all day, BM 1-2 day semi solid, no pain passing them. Looking forward to getting the stitch out and being completely healed again.
Day 12-13 - for some reason I am in a lot more pain. I looked at the incision and it looks good, not red, not hot, so I dont think there is infection. The stitch looks a little longer - maybe I sat on it, or its working its way out now?
I go back to the specialist/surgeon on Sept 27th, he wants to see how I am healing and talk about removing the stitch!

Post Edited (PITA1972) : 9/22/2011 10:53:43 AM (GMT-6)

New Member

Date Joined Sep 2011
Total Posts : 10
   Posted 9/22/2011 11:34 AM (GMT -7)   
Almost 3 weeks post op now. Hardly any pain, fistulotomy incision is healing nicely. Starting to get anxious about the stitch removal, and have a few questions I hope that someone can help with.

My seton does not come out the anus. It is located about 1/2way between where the fistula open was and my anus. Is this normal? Will the seton come out on its own? Will it be another surgery to remove it? If so is it under general anaesthetic? How long is the recovery after that?

Any help would be apprciated

New Member

Date Joined Sep 2011
Total Posts : 10
   Posted 9/28/2011 12:34 PM (GMT -7)   
So, yesterday was my 2nd post op appointment.
The Bad news - seton stitch has to stay in for 8 more weeks confused
The Good news - no further surgery, is needed, as it stands right now. The fistulotmy incision is almost healed (3 1/2 weeks after surgery). I was in a good place yesterday so was able to take in everything the surgeon said.
My fistula was up quite high up and crossed thru the involuntary sphinter muscle up. The seton is a cutting seton and will continue to work its way thru this muscle so that I will not become incontinent.  
There is no surgery to remove the stitch, he will do it right in the office, and it is only a tingling feeling as it is being pulled out.
I will update after November 25,2011 - unless something happens before the stitch is scheduled to come out.
I hope that my experience helps others new to the fistula world... And a BIG SHOUT OUT to all those that posted and gave me the information that I needed during these last few months - THANK YOU!!!!!! smilewinkgrin

Jonny Five
Regular Member

Date Joined Sep 2009
Total Posts : 107
   Posted 9/28/2011 7:33 PM (GMT -7)   
I'm happy to hear things are proceeding well and you are happy with the results from your seton.  I hope everything continues to go well for you.

New Member

Date Joined Sep 2011
Total Posts : 10
   Posted 12/7/2011 7:42 AM (GMT -7)   
I am scheduled to have my seton out at 10:15 today, (14 weeks post op) but it is still leakling a little. What are my chances that he will take the stitch out today? The way it has healed around the seton is now making it a bit uncomfortable to sit directly on my bum.
I would like it out today, but if its not ready I dont want another absess and fistula.... really stressing.

New Member

Date Joined Sep 2011
Total Posts : 10
   Posted 12/7/2011 12:12 PM (GMT -7)   
So it went well, a little discomfort when he was taking the stitch out. I will be back to sitz baths 2 to 3 x daily until it heals (about 3 weeks). It is a bit uncomfortable now, but I think that is because of the location(plus I am at a sit down job). It will be nice to go home tonight and have a soak. There is a little blood oozing, but he said that was to be expected. Provided there is no other issues, I am in the clear.

Thanks to everyone who posted about this procedure. You all have been very helpful

New Member

Date Joined Apr 2012
Total Posts : 1
   Posted 6/2/2012 11:40 AM (GMT -7)   
PITA1972, how are you doing?

New Member

Date Joined Jan 2012
Total Posts : 19
   Posted 6/2/2012 8:35 PM (GMT -7)   
I have to say you are LUCKY.. I had my surgery Feb 12th and I am still wearing gauze between the cheeks and a panty liner.. this Friday May 25th I started running a high fever 104.8 and called my GI.. on cipro and flagel and have a huge new abscess.. so I get to have another surgery and have another seton put in.. he wanted to do it May 31st but I do not want to miss my sons high school graduation.. after the surgery my doctor leaves in a penrose drain ( HORRID PAINFULL) for a week and I am unable to sit at all.. lay down take pain meds.. after its out I still have a hard time for weeks afterwards.. by far the worst thing to happen to me is these perianal abscess's ...
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