Fistula Puns

There's a guthole in my butthole. That is all.

Long story short, my father is a kidney failure patient who goes into hemodialysis 3-4 times a week.

He's got the AV fistula in his arm, but it keeps failing and he has to get it redone the next week. This happens time and time again.

He's not great at explaining it to me, so that's why I've come here. I don't understand why they can't get it right and why they have to fix it all the time. What if it keeps failing? And can anything be done about it?

English is not my first language, so bear with me on all the medical talk. And thank you so much.

I finally got to meet my assigned surgeon for my future bottom surgery today. The actual surgery is far off in the future, since I still haven't got the go ahead from the government, but I got to see pictures of their previous metoidioplasties and was relieved to see that they were according to my aesthetic preferences. Here in Sweden options are very limited, as per the government's restrictions, so it's very "take it or leave it/travel to some other country and do it on your own dime". I've also heard rumors of at least one surgeon who keeps fucking up mastectomies on ftm patients and who is still assigned patients, so I was relieved to see that the results my assigned surgeon produces actually meet my standards...

There is one downside, though. They told me that basically all of their patients who got UL have experienced fistulas. I knew fistulas were common, but my research prior to this led me to believe it was somewhere in the 33% range. 50 at the highest. Being told that it's basically a guarantee is a bit of a red flag for me.

Should I be concerned? They seem ready to fix the problem if it occurs.

I promised myself I would share my experience once I had mostly recovered as I found reading this forum very helpful in the past.

Around 4-5 months ago I began to experience pain after BMs and I was seeing blood when I wiped and experiencing mucus-like yellow discharge.

I saw the doctor after a few weeks as I hoped it would resolve itself, but unfortunately he was unsure of the issue. At this point I was very distressed, so fearing the worst I decided to see a colorectal surgeon privately ASAP the following week.

The colorectal surgeon quickly gave me his initial diagnosis of a small superficial anal fistula, but he wanted to carry out a colonscopy to ensure this was definitely the case and that there was no underlying cause like UC or Crohns.

The colonscopy occured around 3 weeks after the inital consultation, it confirmed his suspicions and there was no obvious underlying cause. We scheduled surgery another 4 weeks after this date. The waits in-between appointments felt agonising, moreso mentally than physically.

When the fistulectomy (removal of the entire fistula tract) surgery finally happened I was relieved, but I was also anxious as I wanted the recovery to go smoothly. I found myself reading other peoples recovery stories and this was often scary, as people more often posted bad experiences.

The post-op recovery itself was not that painful after a few days had passed. But I was still worried for a good 2 months afterwards as I was still experiencing blood and discharge regularly, although less than pre-op. On my followup with the consultant about 6 weeks after the surgery I was told it was healing well. I was still worried due to the bloody and discharge but continued to follow good hygiene practices. After about 10 weeks the blood almost completely stopped which put my mind at ease. The discharge also reduced a great deal.

It's been about 13 weeks now and I hope complete recovery will occur over the coming weeks.

I know how traumatic an experience this can be as much psychologically as physically, but please be reassured that the majority of people recover well. I always thought I would not be one of this majority, I kept looking for negative signs but it is a case of trusting the process and not over thinking it (easier said than done). I wish you all the best and hope you recover quickly and fully.

I was diagnosed with fistula back 2 years go . It didn't bother me these years. It is small and drains itself. But i have decided to go for surgery this year. Is here anyone whose fistula size remained the same and did surgery years later ?

If the AV fistula is in the upper arm, why can't we perform blooddraws or perform IV access in the hand? Or the forearm?

What are the known complications as a result of IV cannulation in these areas?

I’m 10 days out of my fistula repair and noticed on Monday night that my fistula has reopened around its original borders. It’s full depth and a clear shot to my urethra, but half the size it was before. This was my second UL repair this year and we had a lot riding on this being “the one”. Because each time you do a repair, the chance of it being successful drops significantly, with the first initial surgery being the best shot at success.

So that means that what I’m going through now, with the SP and recovery and time off work, is essentially for not. I’ll have to go through it all over again if I want to be able to STP in the end. There’s a minute chance it may heal, but given that the opening is around old skin the chances are super duper slim. My surgeon will be able to give me a better idea of the trajectory and timeline depending on how my pee trial goes in a week and a bit.

My body is beat from back to back surgeries the last year and a half. My mental and emotional energy is drained and I can’t keep this up indefinitely. This new issue pushes the whole timeline to being done back now too.

I feel like I’m so close to throwing in the towel and saying “screw it I’m done” and just stopping where I am. But I can’t because my dysphoria is way worse than it was before surgery and I still can’t pee normally. And being able to STP has been a lifelong dream for me- and I’m so close now. Just a 2mm hole preventing me from doing so. And I’ve invested so much into it at this point that I can’t just stop now.

I’ve had a really, really rough recovery and just can’t seem to catch a break- always having to deal with some unexpected thing and adapting to it.

My biggest fear now is that we won’t be able to make my UL work (meta UL repairs are one of the hardest things the surgeons do) and I’ll be faced with the decision of not being able to STP or having to pivot to phallo in order to-which I really don’t want…

https://preview.redd.it/1jfitpxoq2881.png?width=366&format=png&auto=webp&s=3a6feefc75d5ecd75b287a3dc780f7208122506f

Had a call with my surgeon this morning and made a bit of a game plan for my fistula. This will require its own surgery to fix and will delay my next stage by at least 6 months. So that sucks. But he thinks it’s fixable.

Unfortunately, the fixes come at a cost. He can only do a rotational flap repair from the adjacent tissue because of blood supply issues. And that means I’m very likely to lose length. It may be recoverable with pumping, or it may not. But it should be enough to get me to STP. And that’s the main goal. Sucks to have to concede, but it’s my only option.

We’re planning for a zoom call in 8 weeks with the plastic surgeon to get her thoughts on what the least destructive option is. And then go from there in April- and hopefully that will be my last experience with an SP for life.

I got my SP pulled this afternoon by my local urologist and got his take on fistula repair options. Basically agreed that it’s fixable, but there’s no easy way to do it. He seemed to really get the struggle that comes with having a fistula which was really nice. But he won’t touch me- I’m still the property of another surgeon. So I’m basically back to where I was before surgery and just have to get by for the next few months.

I’m devastated.

I was in so much pain (worst pain of my life) after surgery.. and I ended up with this mindset of “when I’m out of pain, this will all be worth it”, completely forgetting that there was only a 1/3 success rate.

So, I should have remembered that my chances for success were not great, but I was distracted by my recovery.

I’m just feeling so defeated. I waited 7 years to be able to do this surgery and now I’m back at square one

The hole looks like its closed. I still have an open red would near my anus but there doesn't seem to be a hole in it anymore. The pus has ease too. Not as much pain. I'm very confused.

Background: Had surgery recently due to lump growth, hemorriod and skin tag removal. Post surgical complication include what looks like another hemorroid and an open wound in the perianal area that was discharging pus. My pre-surgical issues were all internal and I now have external issues.

Dr said it was a fistula and that I'll need an MRI. Do I still need one if the fistula seems to heal by itself? The dr did say that by the time I have the MRI it may heal.

Hi everyone. I am posting this because prior to husbands surg. I kept reading this in hopes of hearing how it went for others. My husband, very healthy, 51, never was dx with Diverticulitis but I suspected...he had maybe 3 or 4 bad episodes over 15 yrs, and then he stopped eating a jar of peanuts a week and never had another attack, so we assumed it was peanuts that gave him his past pains and that was it. Well, in October we were on a road trip and ( pardon me if I sound crude but I am just gonna say it) he started farting through his dick. Needless to say this was worrisome. Seeing that we were not home our MD told us to get an appointment with a urologist when we came back but not to worry, gave us an rx for an antibiotic, and was told to take one every 4 hours.

Flash forward a week and it goes from small farts to feces. We turned around and drove straight home because when that happens, google was right this time, it had to be a hole between the bladder and the colon. Ok, so we got home, got a colonoscopy, fistulas everywhere, chronic diverticulitis. It took an additional 6 weeks til he had the actual surgery.

We could not get robotic, they were booked up til January and he couldn't continue on in his misery and broth diet. ( He is 6'1. dropped from 193 to 150) had the surgery, with two surgeons a month ago, One to fix the bladder and the other to remove the colon. He had close to 9 inches removed. Unfortunately his worst fear came true, he was sent home with a colostomy bag. This and a catheter. He was miserable for the first two weeks, due to these items. The mid section was sore, but not so bad that he couldn't manage the pain. It was the catheter. Ok after 2 weeks that was removed. He went through, and is still going through depression due to the shit bag, but he is trying different products and seeing which work better for his mobility. This bag should only be for one year. (praying) he is otherwise very healthy so hopefully that will be ok. As for the healing of the fistula, he experiences a few twitches and poking feelings randomly, but he is able to tie his shoes, doesn't use his grabber stick ( very useful btw) and has been getting out and about this past week by himself. He is exhausted though earlier then normal, but I think that is recovery from any surgery.

I have current active fistulas and was diagnosed with Crohns Disease last Spring, but I am beginning to suspect that diagnosis is innacurate. Does anyone know if it's possible to experience fistulas without a corresponding diagnosis of inflammatory bowel disease, or are they always (or usually) correlated?

Thanks!

Hello. Prior to having fistula issues I enjoyed biking and taking photographs in my city. Has anyone been able to ride a bike with fistulas? If so, please share any tips or insights. Thanks!

Has anyone had this with their UC? Has anyone had the surgery? They suspect I have a low level fistula so recommended surgery to lay it open or seton as an option incase it’s higher than thought.

I got my fistula fixed today after over a year of struggling to pee. My surgeon is confident it’ll be what we need to get me to finally be able to STP which I’m stoked on! Also said my urethra is mature and I should be able to form a nice stream once healed with the fluid dynamics back in check. Which will be an amazing upgrade from the current sprinkler head situation.

Did come out of it with an SP catheter, which is less cool, but a necessity. I had some really good post-op nurses who seemed alarmingly impressed by the experience and knowledge I had around SP caths- they said they get a significant number of guys who come in wearing skinny jeans with no thought about how that’ll work with a catheter…

Also discovered the magic of Myrbetriq. I’ve been on it for a few months now due to other bladder issues and holy crap, does it work for spasms. Oxybutynin was not effective for me and I spent every minute the SP was in in agony with debilitating spasms. But not this time. I should be able to actually sleep comfortably too. Huge bonus is no wicked drying-out side effects. I don’t feel like I need to chug water constantly, my eyes don’t feel like sandpaper, and my nose and lips aren’t cracked and bleeding. It’s more expensive, but my insurance covers it, and it makes such a difference.

Weird thing happened though with the admitting clerk- she thought I was a trans woman since my form indicated my “chief complaint” as “gender dysphoria” and my pronouns as he/him… odd interaction.

Hi. I am waiting examination under anesthesia and surgery but every time I go to the toilet, there's blood on the toilet paper, it's not too red but still fresh blood. Is this normal?

My mom has been getting used to having her fistula used for a couple weeks now. I know that dry and itchy skin is a part of having dialysis. I was wondering how do you guys take care of your fistula arms skin? We’ve been hesitant cause we don’t want to do anything that causes a problem

To people who have had anal fistulas before, has anyone experienced an odor or people complaining about a fecal odor, which was related to the fistula? Asking because people tell me I smell funny, and I took a picture of my butthole, and there are lots of fissures, which I always assumed were just from vigorous wiping. But I wonder if its because I have fistulas that maybe leak small amounts of intestine mucous or something.
I dont have any incontinence I have noticed, and I always practice very good hygiene.

Any and all input much appreciated.

I’ve (20M) had a perianal abscess since 12/13 and largely ignored it as I was still in school with finals. I returned home on 12/21 and went to the ER for pain on 12/23 where they diagnosed the abscess and gave me doxycycline+ibuprofen and told me to go check with a PCP which I did on 12/29 who told me to get it drained. So I went to another ER to get an incision and drainage procedure done the same day. However, before they performed the procedure, they performed a catscan and found that I had an anal fistula and the end of my intestine was larger than normal so I might have IBD. They then performed the I&D and I was told to follow up with a colorectal doctor for this.

A few questions I have.

How long should I expect post I&D pain to last? I know it has only been 2 days but I still feel some semblance of pain that I felt when I had the abscess whenever I walk or stand for some time. I can walk and stand easier than before, but I still feel like there is a lot of pressure there. Is this normal or is it possible they may have “missed” a spot or there could have been another abscess? The area around it still seems slightly raised.

I’ve been instructed to take sitz baths but I assumed it was with epsom salt. But when I try it, it is extremely painful/burns as opposed to just warm water. I don’t know how effective soaking an open wound in salt is but should I be taking epsom sitz baths or just hot water sitz baths?

My doctor packed the incision with some string like gauze that I was instructed to pull out the next day. I have done that and I also wear a pad for any pus and blood. When should I expect the majority of drainage to be over?

The fistula really worries me. If a fistula exists, won’t that mean another abscess will form as this one is healing? I really don’t want to get another drainage performed. My doctor told me I should wait a minimum of about 2 weeks before going to a colorectal specialist but I’m afraid another abscess will form in that time. The pain of the first one was unbearable and even after the I&D, I’m still feeling some of initial abscess pain (which I hope will go away as it drains, but please correct me if my assumption is wrong). Shouldn’t I get the fistula checked immediately?

These are some of my primary concerns/questions that I could not ask the doctor who performer the I&D or felt as if I didn’t get adequate enough response. If you have any more advice or support or anything that can help me out, I’d lov

Hey guys, it's been a while since I posted here. Kind of hoped I wouldn't be back but unfortunately here I am. I had a lateral internal sphincterotomy and a fistulotomy back in June and healing has been a battle. Both surgery wounds have healed well but the fissure/fistula have persisted. It's been a lot of up and down. I'll get to the point where I think I'm finally almost healed and then it gets worse again. I'm still soaking daily, using a bidet, and having to avoid any exercises or movements that cause strain or friction whatsoever. I've gained weight and I'm told to exercise but any cardio or lower body exercises cause pain and irritation that will persist until I've given it at least a few days rest. My doctor, the best in my (admittedly small) town, doesn't really have any advice other than give it time but it's been 7 months since surgery and nearly two years since I first developed the fissure and I'm starting to question his advice. Neither my fissure or fistula we're even that bad, I've seen far, far, worse horror stories here, so it really doesn't feel like it should be taking this long to heal. Any thoughts or advice on how I can get my poor behind to heal faster are much appreciated.

What treatment helped it heal? How long did it take? Can you explain how it even heals at all? Are there any lingering issues?

hi y'all. 30F generally healthy, no hx hemorrhoids or any rectal issues.

in early november i experienced the worst pain of my L while having a harder-than-usual BM. i thought i would faint mid-BM, but afterward didn't feel too bad. fast-forward to days later and it just felt like my whole rectum was swollen. i peed and pooped standing for 1 week because sitting hurt so badly, standing hurt so badly. i thought it was a hemorrhoid or a fissure, and i ended up going to urgent care because the perineal pressure was so severe. they palpated and sent me to ED for suspected perianal abscess. get to ED and CT/bloodwork negative for abscess/mass. the only thing seen was free-fluid (ascites) in posterior cul-de-sac (space behind the vaginal wall). pressure/pain improved but the soreness would come and go, irrespective (it seems) of bowel movements. the week before my period the pressure returned and then dissipated during my period.

i have no odor, no drainage, no blood, just intermittent flare-ups of rectal pain/pressure that can be reproduced when i touch the area. the ED doc said there was nothing to see when he visualized the area.

anyone had a similar patchwork of experience? appreciate it!

Hey Cronies,

Was hoping to get some insight from someone with a similar situation to my own. I have had an abscess/ Fistula for the past 5 months. I was on Entyvio until this issue arose and my doc determined that the drug was a fail. He got me approved for Stelara finally and I have taken my first dose about to be on the second one. I am wondering how long this lesion will last and if the Stelara will allow it to heal on it's own or not. Haven't had the most clarifiying feedback from my doc. It's just been like we have to wait and see. Meanwhile I'm stuggling to go day to day while on Levofloxacin with a draining bruised to shit asshole... I've never been more depressed/ frustrated in my life. I know some of you can relate. Thanks for those who cared to read or chime in!

Best to all