Fistulotomy: a brief explanation

  
1. A probe is inserted, and the surgeon will cut open along the entire length of the fistula, from the internal opening to the external opening.

2. The surgeon will then flush out the contents of the now-open tract, and flatten it out.

3. Finally, the surgeon will sew the skin edges of the tract to keep it flat, and ideally the fistula will heal over the course of a month or two into a flat scar.

13 thoughts on “Fistulotomy: a brief explanation

  1. About 10 days ago I had a fistulotomy that is still leaking quite a lot yellowish fluid. Is this normal or did the infection come back 😦 Am also in a lot of pain, even more than the days after my surgery.

    • Well, 10 days after I do think it could be just pus from the wound, but I would check with your surgeon. They might want to take a look. Did you have a seton band put in? If so, then definitely there will be leaking because they are there for drainage.
      I would definitely call the doctor and explain what’s going on. Best of luck!

      • No the seton band was taken out. Do they put a seton back in after having laid open the fistula track?? Is that even possible? I’ll see the surgeon next week, made an appointment because it just doesn’t feel it’s healing on the inside.
        Thank you for your advice

      • Sometimes when they go in for a fistulotomy they end up having to place a seton, that’s why I asked. If not, I don’t think it should be leaking anything other than pus if it worked. Can you tell if the yellow stuff is pus or fecal matter? How are your pain levels? Bowel movements? All of these are things you’ll want to tell your doctor.

      • The pain starts after bowel movements as does the leaking. It’s leaking for many hours brown fluid and then it changes in yellowish fluid. That goes on for many hours and by the time I go to bed it has stopped to start again next morning after bowel movement. This has been going on ever since I developed the fistula. It appears to me nothing changed after the fistulotomy. During the night I’m not in pain even if I don’t take painkillers before I go to bed.
        Going to the bathroom every morning is when another hellish day starts…

      • It could be that the pressure during the bowel movement is pushing out some post-surgery pus, but I would really have a doctor look to see if the fecal matter is still passing through the fistula. The fistulotomy may not have worked this time if there is still leakage. They may talk to you about an advancement flap next, but definitely talk to your surgeon as soon as possible! Sending good vibes!

      • No the flap wasn’t possible; too much scar tissue in there. The LIFT procedure neither so these options are gone.
        I’ll see the surgeon next thursday.
        Thank you for your time to reply

      • Oh, I see. I am glad you’re seeing your surgeon soon! Hope you get some good news. In the meantime, take care, soak as much as possible, and take it as easy as you can!

  2. I have a Seton. Have had it well the 24th will be four weeks. I’m cramping, signs of my menstrual cycle about to start. But I’m bleeding out from my Seton. Do you know why?

    • Hi, do you know if the fistula tract connects… In usher words, is it menstrual blood coming through where the seton is? When did you have the seton put in? It could be bleeding a bit if you just had surgery, or after a bowel movement. We have a support group on Facebook full of wonderful women who might have further input. If interested, let me know and I’ll post the link.
      I’d say if it’s been a few weeks or more since surgery, it’s worth checking in with your doctor. Best of luck!

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