I had a large vaginal fistula a few months ago (the hole in the vaginal wall was at least 1" in diameter at the widest part... I have a perm. ileostomy, so the fistula did not connect to bowel, but tunneled out and caused my closed rectal area to open up. I had surgery in April to close the fistula... gracilis flap repair with mesh... VERY painful, and since they cut so much in the rectal area, not the most breathable area, the external wounds were very slow in healing. My doctor kept checking and waiting, checking and waiting, and the larger part of the wound closed... the original fistula exit closed, but a deep hole developed a little higher, near my tailbone. Went in today to check it out and discovered that a second, smaller fistula has now formed. The orginal, huge fistula has closed (Thank You, God!!), but this new, smaller hole is lower in the vaginal wall and needs to be repaired. Instead of a flap repair, the dr. told my husband that this will be a "wrap repair" using a smaller muscle, a very small cut, and that the recovery will be much, much easier. He said this hole is tiny and once we complete the muscle "wrap" the external wound caused by the tunneling from the vaginal wall to my bottom will heal quickly.

Questions:
1. Has anyone had experience with muscle flap and muscle wrap? I know all about the flap, and would like a comparison of the two to give me an idea of what to expect.
2. Once this has happened twice, what are the chances that it will stop. I do not have Chron's. I have had an extensive history with infections in the perineal area... the infections and scar tissue seem to be causing the holes in the vaginal wall and subsequent fistulas.
3. I am a teacher, about to start back to school. With the muscle flap repair, I missed 2 months of work. I am hoping to go back to work just after maybe 1 1/2 weeks with the wrap. Is this reasonable (I can ride to/from work with a friend).

Thanks for any help you can provide. This was an overwhelming day learning that a second fistula has developed. I want to put this all behind me ASAP!

I don't know if this is what you are taking about, but my sphincters were damaged after my fistula surgery and they did a repair job on them. Thinking of the sphincter normally as a hole, instead, imagine a teardrop shape laying on it's side. The pointy side was the weak side, so they tried to take from the stronger sides to wrap working muscle around, overlapping the weak area to get it working as good as possible. I do not know if this is the type of procedure you are describing.

I had my surgery the last week of July, and 3 weeks later I was well enough to fly back to Texas to go back to school. I wanted to stay where I had the surgery long enough to determine if the repair would break down (due to stool passing anear the new repair job leading to infection,. etc.), in which case they would do a temp ostomy to divert and promote better healing. If memory serves, I probably would have been able to go to work (on pain meds) by 1.5 weeks post surgery.

I checked into the hospital for this surgery the day after I got back from my honeymoon, and because I had the surgery done in Minnesota, but was living in Texas where they started school the first week of August, my new hubby had to fly home without me after my surgery, to start school before me.

If all goes well, and your procedure is something similar, it sure sounds like it could be doable?

Good luck!

Faith,
I would check out why you keep getting these fistulas first...the problem is that your body is trying to evacuate something and making holes in you in order to do so...if you close this one is it just going to make another hole?
Are they just symptoms of something else going on that needs to be fixed first?
Ask the doc if the fix is just going to plug the hole or fix the problem?
Sharon