Post-Surgery Concerns After Fistula Procedure: Pain, Discharge, and Recovery

Postoperative issues following fistula tract surgery (157393)

Hello, Doctor.
I apologize for the inconvenience, but I have some questions regarding my condition (157393).
I underwent fistula surgery on May 7, and I mistakenly referred to the body part incorrectly, which may have led to some misunderstanding.
The opening of the fistula is located below the scrotum (in the perineum), close to the scrotum and slightly to the left.
The internal opening was identified and treated during the surgery.
When I mentioned that there was no internal opening, did you mean that the internal opening is considered healed based on your examination results? You mentioned that there is no opening now.

1.
In the case where the internal opening is considered healed, is it normal for me to feel pain when I apply pressure to the anal area?
2.
When squatting, if there is increased tension at the wound site, is it normal for the bleeding to come from the fistula opening (that hole) and not from any other surgical wounds?
3.
Regarding the yellow-green discharge, if I press on the fistula area and the discharge appears yellow, but when it is on the gauze it appears yellow-green (not only from the fistula opening but also from the surrounding wounds), and there is no swelling or pain, does it have a similar odor to yellow pus?
4.
I would like to know if it is safe to ride a motorcycle (the position may press on the wound).
I rode a little last week and did not experience pain at the wound site.
If riding is allowed, is it safe for long durations?
I apologize for the trouble and appreciate your patience in answering my questions.
Thank you.

Niming (Xu), 20~29 year old female. Ask Date: 2020/06/18

Dr. Ke Fangxu reply Surgery

1.
If the wound has not fully healed, mild tenderness should be considered normal as long as there is no redness, swelling, heat, or pain.
2.
Mild bleeding before the wound has completely healed is also normal.
3.
I cannot provide a definitive answer on this matter; it is better for the operating physician to examine it in person, as online consultations may not be able to assess the situation accurately.
4.
Riding a motorcycle for a short period should be fine, but prolonged riding is generally not recommended, especially before the wound has fully healed.

Reply Date: 2020/06/18

More Info

After undergoing a fistula procedure, it's common to have concerns about pain, discharge, and the overall recovery process. Let's address your questions one by one, providing clarity and guidance based on medical knowledge.

1. Pain at the Internal Opening: It is not unusual to experience some discomfort or pain when pressure is applied to the area around the internal opening of the fistula, especially during the healing process. The tissue in that area is sensitive, and any manipulation can cause discomfort. However, if the pain is severe or worsening, it would be prudent to consult your healthcare provider to rule out any complications such as infection or improper healing.

2. Bleeding During Bowel Movements: Experiencing some bleeding from the fistula opening during bowel movements can occur, particularly if there is increased tension or pressure in the area. This is generally considered normal, especially if the bleeding is minimal and stops quickly. However, if you notice significant bleeding or if it persists, you should seek medical attention to ensure that there are no underlying issues.

3. Discharge Color and Consistency: The presence of yellow-green discharge can indicate a few things. Yellow discharge can be a normal part of the healing process, but if it turns green or has a foul odor, it may suggest an infection. The fact that you mentioned the discharge is yellow when you press on the area but appears yellow-green when covered with gauze could indicate that the gauze is absorbing additional fluid or pus from the surrounding tissue. If there is no accompanying pain, swelling, or fever, it may not be a cause for immediate concern, but monitoring the situation is essential. If the discharge continues to change in color or consistency, or if you develop other symptoms, consult your doctor.

4. Riding a Motorcycle: If you are able to ride a motorcycle without experiencing pain at the site of the surgery, it may be acceptable to do so. However, you should be cautious about the duration and intensity of the ride. Prolonged pressure on the area could lead to discomfort or complications. It's advisable to listen to your body; if you feel any pain or discomfort while riding, it would be best to stop and allow more time for healing. Additionally, consider discussing this activity with your healthcare provider, as they can provide personalized advice based on your specific recovery progress.

In summary, while some pain, discharge, and bleeding can be normal after a fistula procedure, it is crucial to monitor your symptoms closely. If you experience significant changes, increased pain, or any signs of infection (such as fever, increased redness, or swelling), you should reach out to your healthcare provider promptly. Recovery can take time, and following your doctor's post-operative care instructions is vital for a successful healing process. Always prioritize your health and well-being, and don’t hesitate to seek medical advice when in doubt.

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