Post-Surgery Concerns After Fistula Procedure: What to Expect

Post-operative issues related to fistula surgery?

Hello Doctor, thank you for taking the time to respond to my questions! I underwent a fistula surgery on April 28 (the doctor indicated that the wound is inside the anus, not outside).
After more than a week, I no longer experience pain, but there is still a small amount of yellow discharge.
Since the wound is on the inside, I cannot see the healing progress.
How long does it typically take for the discharge to stop before I can stop sitz baths? Additionally, I take sitz baths 3-4 times a day and use cotton balls at the anal opening to absorb pus and blood.
However, today I noticed three pimple-like bumps near the anus that cause slight pain when touched or rubbed, but they are not swollen and are located completely different from where the original fistula was.
Could this be due to returning to work, soaking too long, or using cotton balls? During my last follow-up, the attending physician only mentioned that the wound was healing well (and I do feel less pain), but the sudden appearance of three bumps is concerning.
Thank you for your help! (I have taken photos but am unsure how to attach them; I can provide them if needed, thank you.)

Niming, 20~29 year old female. Ask Date: 2020/05/08

Dr. Li Zhonghuai reply Surgery

Hello! Fistula wounds are generally not very visible from the outside.
Please return for a follow-up appointment so the doctor can assess the healing progress of the wound and determine whether you need to continue sitz baths.
Also, please have the doctor evaluate the three raised tissues to see if any treatment is necessary.
Take care! Changhua Hospital cares about you!

Reply Date: 2020/05/08

More Info

After undergoing a fistula procedure, it is common to have concerns about the healing process and any unusual symptoms that may arise. Based on your description, it sounds like you are experiencing some typical post-operative issues, but let's break down your concerns for clarity.

1. Discharge and Healing Time: It is not unusual to have some yellow discharge (pus) after a fistula surgery, especially in the initial weeks. This discharge can be a sign of healing, but it is essential to monitor its characteristics. If the discharge is minimal and not accompanied by a foul odor or increased pain, it may indicate that your body is healing properly. Typically, the discharge should decrease over time, and you can expect it to stop within a few weeks to a couple of months, depending on the individual healing process. You can continue to sit in warm baths (sitz baths) as they can help soothe the area and promote healing. However, if the discharge persists beyond a reasonable timeframe or worsens, it is crucial to consult your surgeon.

2. Sitz Baths and Cotton Balls: Sitz baths are generally beneficial after anal surgeries, as they help keep the area clean and can alleviate discomfort. However, it is essential to ensure that you are not soaking for too long, as prolonged exposure to water can sometimes irritate the skin. Using cotton balls to absorb discharge is acceptable, but ensure they are changed frequently to avoid any risk of infection. If you notice any irritation or discomfort from the cotton balls, it may be best to discontinue their use and consult your doctor for alternative methods.

3. New Bumps Near the Anus: The appearance of new bumps or lesions near the surgical site can be concerning. These could be a variety of things, including skin irritation, small cysts, or even remnants of the healing process. Given that you mentioned they feel like small pimples and are not swollen, they may not be a significant concern. However, if they are painful, persistent, or change in appearance, it is essential to have them evaluated by your healthcare provider. It is possible that returning to work and increased activity could contribute to irritation in the area, especially if you are sitting for extended periods.

4. Follow-Up Care: Since your last follow-up indicated that your wound was healing well, it is a positive sign. However, if you have any doubts or if your symptoms change, do not hesitate to reach out to your surgeon. They can provide you with the best advice tailored to your specific situation and may want to examine the new bumps to ensure they are not a sign of complications.

In summary, while some discharge and discomfort are expected after a fistula procedure, it is essential to monitor your symptoms closely. Continue with your sitz baths, but be mindful of the duration, and keep an eye on any new developments in the area. If you have concerns about the bumps or if your discharge changes, please consult your healthcare provider for further evaluation. Your health and comfort are paramount, and your doctor is there to help you navigate this recovery process.

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