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7 replies

Update on outlet narrowing, perianal fistula, and seton drain.

rachelravenrachelravenMember
So today, Dr Schraut replaced my seton drain for my perianal fistula. It broke in the office last Monday... the week without it showed me that YES, I need it. The fistula started the drain, fill, burst cycle again, something that had gone away with the drain in. Glad to have my exotic piercing back. Wink

He also did my second outlet anastamosis dilation. He wants to do one more in about 2 weeks, then teach me self dilation techniques. Everything looked good otherwise, and overall, I've felt "better" recently, with the opening made larger by dilation, and when the seton was in place (sad it broke... but at least I have my new one. Seton #1 was blue... #2 is yellow, haha).

So that's my update for the folks who were talking with me about these issues.

Anyone do self dilations? I did some mild ones this past week with a taper and/or finger, but he might float me a Heger. How often do you do it? Has it kept you open?

Anyone ever have a perianal fistula and have it repaired? I'll have the seton indefinitely, but have read about repairs, though they sound painful. But can I live with this drain indefinitely? I guess the answer is yes... But how inconvenient!
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SubskySubskyMember
I had a perianal fistula that I ended up having a fistulotomy to repair. I was experiencing the draining, healing, swelling cycle and it was getting very bothersome.

It was left open to heal from the inside, he cut through maybe an inch of sphincter muscle, said it was in a good spot for repair and wasn't too deep.

After it healed I never have had a fistula again, so yes I would recommend getting it fixed.
G GinabelloMember
Good to hear Rachel! I am having my MRI thanks to your advice(: Surgeon keeps telling me I'm healing but I've been going through the same cycle now for almost 7 months more scary then bothersome for me!!I have a question for you how long does it take and is it done in the office( the seton)? I have planned a family vacation in Italy fot July and am feeling a little nervous about my situation..
rachelravenrachelravenMember
He placed the seton the first time in the OR, this time in the GI lab, under conscious sedation (Versed and Propofol). Took him longer time one, b/c the anal connection was a bit hard to find, but this one took way less time. First one took me about 3 days to lose that "violated" feeling, but this morning was the placement of number two, and I'm pretty fine, apart from mild stinging when I use the toilet (but the fistula alone could sting worse AND hurt, when it'd cycle, way worse than now). Had I not had the narrowing, this seton would be a breeze.
SubskySubskyMember
The incision definitely affected my outer sphincter muscle slightly, the scar tissue is probably 4mm wide. Doesn't affect my control at all though.

I didn't have a diverting ileo while it healed, so it was a long, painful process. All the sitz baths with epsom salts. My jpouch surgery was also only a one step surgery, with the j-pouch creation and hook up in one go.

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