Post-Surgery Complications of Anal Fistula Treatment

Formation of anal fistula after surgery?

Hello Doctor: In mid-2014, I underwent drainage surgery for an anal abscess in an outpatient setting.
After that, I started paying attention to my diet.
Later, I noticed a hard lump next to the anus, which was not uncomfortable and did not present any issues.
However, I was concerned it might develop into a fistula, so I decided to have surgery at the end of September.
Afterward, the wound did not heal for 2-3 months, and eventually, I began taking traditional Chinese medicine to help my body heal, which started to work.
However, the internal area would swell again, requiring me to puncture it with a needle to drain it.
Interestingly, what came out was only a small amount of pus, mostly blood.
Now, a year and a half later, my condition has improved with gradual care, but whenever I start to heal, after a few days, if I feel a bit more fatigued, it swells and bleeds again.
Could this be a fistula? I can't take it anymore and want to have surgery again, but I'm worried it might just be enduring more pain, and I don't know which doctor to consult.
I feel helpless.

Joe, 30~39 year old female. Ask Date: 2016/03/01

Dr. Xu Kaixi reply Surgery

Your condition may be due to poor wound healing after anal fistula and abscess surgery, where unhealthy tissue may remain within the scar, leading to recurrent flare-ups.
A more fundamental treatment approach would involve considering a repeat surgical debridement to excise the areas causing recurrent inflammation and recurrence.

Reply Date: 2016/03/01

More Info

Understanding post-surgery complications of anal fistula treatment is crucial for patients who have undergone procedures related to anal abscesses or fistulas. Your experience highlights several important aspects of recovery and potential complications that can arise after surgery.

Firstly, it’s important to recognize that anal fistula surgery, while often necessary to prevent recurrent infections and complications, can lead to a variety of post-operative issues. Common complications include delayed wound healing, infection, and recurrence of the fistula. In your case, the prolonged healing of the wound and the presence of a hard lump near the anus suggest that there may be residual issues related to the original fistula or possibly the formation of a new one.

The fact that you have experienced swelling and bleeding, particularly if the discharge is primarily blood with only a small amount of pus, raises concerns about the possibility of a fistula or an abscess that has not fully resolved. Fistulas can sometimes form as a result of incomplete healing or infection following surgery. They can also be associated with conditions such as Crohn's disease, which can complicate the healing process.

In terms of treatment options, if you suspect that you may have a recurrent fistula, it is essential to consult with a colorectal surgeon who specializes in this area. They can perform a thorough examination, possibly including imaging studies like an MRI or endoanal ultrasound, to assess the extent of the problem. Surgical intervention may be necessary if a fistula is confirmed, and the type of surgery will depend on the specific anatomy of the fistula and any associated complications.

Regarding your concerns about undergoing another surgery, it is understandable to feel apprehensive, especially after experiencing prolonged discomfort and complications. However, it is important to weigh the potential benefits of surgery against the risks of ongoing symptoms and complications. If the fistula is not treated, it may lead to further infections, abscess formation, and chronic pain, which can significantly impact your quality of life.

In addition to surgical options, some patients find relief through conservative management strategies, such as dietary modifications to ensure soft stools, sitz baths to promote healing, and possibly the use of medications to manage pain and inflammation. However, these measures may not address the underlying issue if a fistula is present.

Lastly, it is crucial to find a qualified healthcare provider who can guide you through this process. Look for a colorectal surgeon with experience in treating anal fistulas and related conditions. They can provide you with a comprehensive evaluation and discuss the best treatment options tailored to your specific situation.

In summary, while post-surgery complications from anal fistula treatment can be challenging, understanding the potential issues and seeking appropriate medical advice can lead to better outcomes. It is essential to address any ongoing symptoms promptly to prevent further complications and improve your overall well-being.

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