A fistulotomy is a surgery performed to treat a fistula. A fistula happens when two of your organs or vessels form an abnormal connection. These organs or vessels would in any other case not be connected. Anal fistulas happen when your perianal skin, the skin around the opening of your anus, forms an abnormal connection with the surface of the anal canal.
Anorectal fistula: which forms between your anal canal and the skin around your anal opening
Rectovaginal fistula: which happens when a hole develops between the vagina and the rectum
Colovaginal fistula: when a connection develops between the vagina and the colon
A fistulotomy is an outpatient procedure, meaning it probably will not need being hospitalized. The actual procedure takes about an hour. You’ll also want to plan for more time before and after the procedure.
If your fistula is small and shallow, your doctor may be able to do the procedure in their office using local anesthesia. If the fistula is big, you may have to go to a hospital and have general anesthetic.
At time of the fistulotomy, your doctor will make an incision in your body to open up the abnormal connection between the two organs. This is capable of causing some complications following the surgery, including:
Bleeding at the site
Bowel incontinence, if it has to do with the anus or rectum
Abscess or recurrence of the fistula
This procedure varies from a fistulectomy. During a fistulectomy, the fistula is totally removed.
Your doctor will ask you to go home with instructions to keep the wound clean and packed with gauze. Packing it with gauze will assist in preventing your skin from healing over the wound, which could make another fistula to form. The wound has to start healing from the inside out. Your doctor will tell you how to care for your wound, but feel free to ask any questions. Proper home care will improve your recovery.
You will need to rest for the first 24 hours after the procedure, though you should resume your normal diet following the surgery. Ask family members or friends to assist you in the house, and plan to take at least a day off of work. You should stay away from strenuous activities, including workout and heavy lifting, for at least five to seven days. Your doctor may suggest you wait a little longer to resume all of your normal activities. Always abide by your doctor’s recommendations.
You may have some cramping and nausea right away following the procedure. You may additionally experience constipation as a side effect of your pain medications. If you experience this, talk to your doctor about using a stool softener, which can assist you resume normal bowel function.
It may take one to three months to fully recover from a fistulotomy.
When you visit your doctor before the procedure, they will review your symptoms and carry out a physical exam. If you’re experiencing a severe pain and drainage near the area of the fistula, it may be a signal that you have an infection.
Your doctor may also use any of the following diagnostic procedures to assist determine a course of treatment:
Endoscopic ultrasound: This ultrasound creates images of your pelvic floor and sphincter muscles to assist your doctor detect the location of the fistula.
Fistulography: For this procedure, a contrast solution is injected into the fistula and then an X-ray is done of the area.
Anoscopy: Your doctor may use this procedure to survey your anal canal.
MRI:This can also assist your doctor locate the fistula if it’s hard to access during a physical exam.
Fistula probe:Your doctor may put this instrument into the fistula.
CT scan: This system may allow your doctor to monitor the flow of contrast dye between two areas of your body that shouldn’t be connected.
Your fistula may develop once more after the procedure, and you may experience incontinence as a complication if the anus or rectum are involved. Base on the cause of your fistula, this procedure may not be the the most preferred treatment for you. Share all of your symptoms and health history with your doctor to assist him make an informed diagnosis and treatment plan.
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