Post-Surgery Complications After Anal Fistula Treatment: Symptoms - Surgery

Postoperative issues following anal fistula surgery?

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Hello Dr.
Ke,
In July 2021, I underwent surgery to drain an anal abscess, which left a significant wound (approximately 3-4 cm long) that was almost deep enough to reach the pelvis, located in the lower left area of the anus.
After healing, I had another surgery in August due to a large area of infection from a boil (also near the anus, on the right side).
By December, I began to experience discomfort at the scar from my first abscess surgery, where pressing would produce a bubbling sound (or a liquid sound), though this occurred intermittently, usually after physical activity or overexertion (sitting too long, heavy lifting at work, exercising).
During a follow-up visit, Dr.
A mentioned that there might be signs of recurrence, so he prescribed antibiotics.
However, after taking them for two months, the recurrence continued.
The anal sphincter seemed to alternate between feeling better and then painful again, but there were no visible pimples or pus, and my bowel movements did not contain pus or blood.
Eventually, I experienced severe pain when passing gas, which prompted me to seek an examination at the Colorectal Surgery Department of China Medical University Hospital in Taichung (MRI).
Dr.
B diagnosed me with a high-level complex fistula (two fistulas), with the main one having an internal opening but no external opening, and a branch running alongside it.
Consequently, I had surgery in mid-March 2022.
After the surgery, gas no longer traveled to the old scar, but during the procedure, only the superficial internal opening of the main fistula was visible, and Dr.
B stated that the other branch was not visible, so it was not addressed.
Initially, the wound healed well for about a month after surgery, and gas no longer entered the old scar.
However, around late April, after receiving a vaccine, I experienced discomfort again, and the old abscess scar began to produce that liquid sound upon pressure, along with a small amount of jelly-like blood during bowel movements.
The bleeding was minimal and resolved the next day without pain (the sound also disappeared, but returned after a couple of days of exercise, although there were no traces of blood during bowel movements).
I returned to Dr.
B for a check-up, and he indicated that there seemed to be no significant issues, prescribed a week of antibiotics, and reassured me that this was likely unrelated to the vaccine.
My question is: what is the liquid sound coming from the wound of my first abscess surgery? There is no pain when pressing, but the sound makes me feel uneasy.
When lying down, I cannot produce any sound, but standing and pressing does create a sound.
If I rest for a day without putting pressure on the scar, the sound gradually diminishes, but I cannot lie in bed every day.
Both doctors have stated that they did not observe any signs of pathology and performed a digital examination.
Dr.
B suggested that it might be a residual effect from my first abscess surgery, advising me to return for check-ups and medication if discomfort arises.
However, I feel that the wound has been present for a long time (even though it has been infected repeatedly since December until the surgery in mid-March) and I can feel and hear liquid beneath the skin or fat with minimal pressure, which feels like inflammation of the sphincter.
Although it does not significantly impact my daily life (sitting, lifting, light exercise, standing for long periods, etc.), I may feel slight discomfort when sitting, but it subsides once I am seated.
I previously asked Dr.
B if we should open it up to drain it, but he refused, stating that since there were no visible issues, there was no need for incision and drainage.
Dr.
A provided a similar response.
Is this a common issue after abscess surgeries? After all, not many people might be as tempted as I am to press and poke at the wound, leading to unnecessary anxiety.
Both doctors seem unconcerned about this issue, and I am worried that ignoring it could lead to worsening conditions requiring another surgery.
I've been dealing with this condition for almost a year now, and I have consistently sought treatment and care.
After each surgery, I have adhered to a three-week recovery period, practicing sitz baths and maintaining a proper diet, avoiding smoking and alcohol, and taking all necessary supplements.
I also engage in fitness activities, and I believe I understand health concepts better than most.
Honestly, this situation has been exhausting and has left me feeling quite disheartened.
Thank you for taking the time to read this, and I wish you all the best.

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Ye Xiansheng, 40~49 year old female. Ask Date: 2022/05/09