Post-Surgery Concerns After Fistula Treatment: Common Questions Answered

Post-fistula surgery

Hello Doctor, I underwent a fistula treatment surgery on June 27, and I have some questions that I hope you can take the time to answer.
Thank you.
1.
It has been a month since the surgery, and I still experience pain at the wound site (for example, when sitting on a hard chair, walking, or lying in bed).
Sometimes it suddenly itches.
Is this normal? Additionally, while showering at night, I felt a small lump near the suspected sutured area.
Could this indicate a recurrence of the fistula? (However, I did not see anything unusual when looking in the mirror.)
2.
My attending physician recommended that I take sitz baths twice a day, but during my menstrual days, I only rinsed the area with warm water for 4-5 minutes.
Will this have any impact? Are there alternative methods I can use during my period instead of sitz baths?
3.
I often feel the urge to have a bowel movement, but when I go to the bathroom, I can't pass anything.
When I wipe with wet wipes, there is blood.
Is this normal? Additionally, after having a bowel movement, I occasionally experience intense itching, which can only be relieved by taking a sitz bath.
Is this also normal?
4.
The doctor prescribed me an antibiotic ointment to apply, but it causes pain at the wound site, and the next day, the sanitary pad I used is particularly soiled.
As a result, I haven't been applying it much.
Will this have any consequences?
5.
Occasionally, when I stay up late, I wake up with increased pain at the wound site compared to when I get a good night's sleep.
Is this normal? Thank you, Doctor, for taking the time to answer my questions.

Ye Zi, 20~29 year old female. Ask Date: 2022/07/26

Dr. Ke Fangxu reply Surgery

1.
Mild pain within one month post-surgery is normal, and a lump may be scar tissue from the healing process.
To determine if it is a recurrence, please consult your surgeon; however, generally, it does not occur this quickly.

2.
It does not affect the ability to rinse with a handheld showerhead.

3.
After surgery, it is important to avoid constipation to prevent straining, which can cause bleeding from the wound.
It is also common to experience itching at the wound site; you may ask your doctor for a topical ointment.

4.
Oily ointments are more prone to contamination; please discuss with your doctor about switching ointments.
It is also acceptable not to use any ointment.

5.
Staying up late and sitting for prolonged periods can indeed cause pain at the wound site; please try to avoid these activities.

Reply Date: 2022/07/26

More Info

Post-surgery recovery from a fistula treatment can be a challenging experience, and it’s understandable to have concerns about the healing process. Let’s address your questions one by one, providing clarity and guidance based on medical knowledge.

1. Pain and Itching After Surgery: It is not uncommon to experience pain and itching at the surgical site several weeks post-operation. The pain can be exacerbated by sitting on hard surfaces or during physical activity, as these actions can put pressure on the healing area. The presence of a small lump near the incision site could be a normal part of the healing process, such as scar tissue or a small cyst, but it’s essential to monitor it. If you notice any changes, such as increased size, redness, or warmth, it would be prudent to consult your doctor to rule out any complications, including recurrence of the fistula.

2. Sitz Baths During Menstruation: Your doctor’s recommendation for sitz baths is aimed at promoting healing and comfort. If you are unable to take sitz baths during your menstrual period, using warm water to wash the area is a suitable alternative. The key is to maintain cleanliness and avoid any irritants. Ensure that you are gentle and avoid any harsh soaps or products that could irritate the area.

3. Bowel Movements and Bleeding: Experiencing a strong urge to defecate without being able to do so can be frustrating and may indicate a temporary issue with bowel function, possibly related to anxiety about pain or discomfort. The presence of blood when wiping can be concerning; however, it may be due to irritation of the surgical site or hemorrhoids, which can occur after surgery. It’s crucial to keep the area clean and to use gentle methods to avoid further irritation. If the bleeding persists or worsens, or if you experience severe pain, you should contact your healthcare provider.

4. Use of Antibiotic Ointment: If the antibiotic ointment prescribed is causing pain or discomfort, it’s important to communicate this to your doctor. While these ointments can help prevent infection, they should not cause significant pain. If you find that the ointment is leading to increased discomfort or unusual discharge, your doctor may suggest an alternative treatment or method of care.

5. Pain After Staying Up Late: It’s not unusual for fatigue and lack of sleep to exacerbate pain perception. When the body is tired, it may be less effective at managing pain, and you may be more sensitive to discomfort. Ensuring adequate rest and managing stress can be beneficial for your overall recovery. If you notice a consistent pattern of increased pain after nights of poor sleep, it may be worth discussing with your healthcare provider.

In summary, while some discomfort and symptoms can be normal during recovery from fistula surgery, it’s essential to stay vigilant and communicate with your healthcare provider about any concerning changes. They can provide personalized advice and interventions to help you through your recovery process. Remember to prioritize self-care, maintain a healthy diet, stay hydrated, and follow your doctor's recommendations for optimal healing.

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