Hi, @Joey A. Do you know exactly what surgery you’re scheduled for? There are a variety of procedures that can be performed on a fistula, with varying results. The simplest (and least risky) is suggested by the name you gave this thread: placement of a draining seton under anesthesia. No one loves their seton, but often they like it better than the fistula’s behavior before treatment. Good luck!

Hi Scott,  I'm 99.9% certain that she said "seton".  What do you know about this procedure?  Thanks!

A draining seton is likely what she has in mind (as opposed to a cutting seton). A seton is a loop of a flexible thread that passes through the full length of a fistula and completes the loop outside the fistula. For a perianal fistula the inner opening might be somewhere along the anal canal, though fistulae can also follow complicated and branching paths. The idea is to keep the fistula open so fluid doesn’t build up and cause painful pressure. It can be difficult to locate the internal opening of a fistula, but usually the thread can be passed through. It’s a nuisance to have the seton at the anal opening, but generally better than repeated abscesses. Folks here have reported different experiences with different seton materials (some can be fragile and prone to breakage, and some may be more comfortable than others). You might ask the doctor what seton materials are possible and perhaps be able to discuss the pros and cons of each.

Thank you, Scott!