Post-Abscess Surgery: Do I Need Fistula Surgery?

Post-operative issues following abscess surgery?

At the end of July this year, I underwent an abscess surgery.
About a month later, I visited my original doctor for a follow-up examination, and he mentioned that it had developed into a mild fistula.
However, up to now, the wound has not been discharging pus or any fluid; it only hurts slightly during occasional constipation, but there is no bleeding or pus.
Should I still consider undergoing fistula surgery? Although I have read that fistulas do not heal without surgery, is there a way to coexist with it peacefully? Additionally, do I still need to continue warm water sitz baths? It feels like the wound has already healed.
Thank you.

YMS, 30~39 year old female. Ask Date: 2019/11/04

Dr. Ke Fangxu reply Surgery

If there is currently no pain, bleeding, or discharge, you can observe the situation for a while.
However, if the symptoms recur, surgery will be necessary for a definitive cure.
If surgery is not considered, antibiotic treatment can only be used during flare-ups of the fistula, but there is no guarantee that it won't develop into a complex fistula.
If the wound has already healed, warm sitz baths are not necessary.

Reply Date: 2019/11/04

More Info

After undergoing abscess surgery, it is not uncommon for patients to have concerns about the development of a fistula. A fistula is an abnormal connection between two body parts, often occurring as a complication of an abscess. In your case, it seems that your doctor has diagnosed you with a mild fistula, but you are not experiencing significant symptoms such as pus drainage or bleeding, which is a positive sign.

Understanding Fistulas
Fistulas can develop after an abscess due to the inflammation and tissue damage caused by the infection. In many cases, if a fistula is small and asymptomatic, it may not require immediate surgical intervention. However, if the fistula becomes symptomatic or leads to recurrent infections, surgery may be necessary to prevent further complications.

Do You Need Surgery?
In your situation, since you mentioned that the wound has not been draining any pus or fluid and that you only experience mild discomfort during bowel movements, it may be possible to manage the condition conservatively. Here are some considerations:
1. Monitoring Symptoms: Keep an eye on any changes in your symptoms. If you start experiencing increased pain, swelling, or drainage, it would be advisable to consult your doctor again.

2. Surgical Consultation: It might be beneficial to have a follow-up appointment with your surgeon or a colorectal specialist. They can provide a more thorough evaluation of the fistula and discuss the potential need for surgery based on your current condition.

3. Quality of Life: If the fistula is causing you discomfort or affecting your quality of life, surgical intervention might be warranted, even if the symptoms are mild.

Can You Coexist with a Fistula?
While some patients may live with a fistula without significant issues, it is essential to understand that this is not always the case. Fistulas can sometimes lead to complications, including recurrent infections or abscess formation. Therefore, while it is possible to "coexist" with a mild fistula, regular monitoring and communication with your healthcare provider are crucial.

Warm Water Sitz Baths
Regarding your question about warm water sitz baths, these can be beneficial for promoting healing and comfort in the anal area. Sitz baths can help reduce discomfort, promote blood flow to the area, and keep the surgical site clean. If you find them soothing and they help alleviate any discomfort, it is advisable to continue using them.

Conclusion
In summary, while you may not need immediate surgery for your mild fistula, it is essential to maintain open communication with your healthcare provider. Regular follow-ups and monitoring your symptoms will help ensure that any potential complications are addressed promptly. If you experience any changes in your condition, do not hesitate to seek medical advice. Your health and comfort should always be the priority.

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