Fistula Surgery Recurrence: What You Need to Know - Surgery

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Fistula surgery, particularly for anal fistulas, can be a challenging journey, and it's understandable to have concerns about recurrence and healing. Based on your description, it seems you have undergone two surgeries for your fistula, and now you are experiencing some bleeding from the anus, which has raised concerns about the healing process and potential recurrence.

Firstly, it is important to understand that the healing of anal fistulas can be quite variable. The internal opening of the fistula, which connects to the anal canal, can take longer to heal than the external wound. In many cases, the external wound may appear healed while the internal portion may still be in the process of healing. It is not uncommon for the internal opening to take several weeks or even months to fully heal, especially if the fistula was complex or if there were any complications during the initial surgeries.

The fact that you are experiencing bright red blood during bowel movements could be indicative of several things. It might be related to the healing process of the internal opening, or it could be due to irritation or trauma during bowel movements. If the bleeding is minimal and not accompanied by severe pain or other concerning symptoms, it may not necessarily indicate a recurrence of the fistula. However, any new bleeding should be evaluated by your surgeon or a specialist to rule out any complications.

Regarding your concern about whether it is normal for the internal opening to remain unhealed after 90 days, it is essential to consult with your healthcare provider. They can assess the healing process through a physical examination and may recommend imaging studies if necessary. While some patients may heal within a few weeks, others may take longer, and factors such as the complexity of the fistula, the presence of infection, and individual healing rates can all play a role.

You mentioned that you have been diligent in your post-operative care, including bathing and applying medication. This is crucial for promoting healing and preventing infection. Continuing to maintain good hygiene and following your doctor's instructions is essential. If you notice any signs of infection, such as increased redness, swelling, or discharge, it is vital to seek medical attention promptly.

As for the fear of undergoing a third surgery, it is understandable to feel apprehensive. Many patients share similar fears after experiencing multiple surgeries. It is important to communicate openly with your healthcare provider about your concerns. They can provide reassurance, discuss the likelihood of recurrence, and explore alternative treatment options if necessary.

In summary, while it is not uncommon for the internal opening of a fistula to take longer to heal, any new bleeding should be evaluated by a healthcare professional. Maintaining good hygiene and following post-operative care instructions are crucial. If you have concerns about recurrence or the need for further surgery, discussing these with your surgeon can help alleviate your fears and provide clarity on the next steps in your treatment plan. Remember, you are not alone in this journey, and seeking support from your healthcare team is essential for your recovery.