Are you experiencing discomfort due to pain, swelling, or discharge from your anus? This can be so bothersome that it can make it difficult to walk, sit, or perform daily activities. The cause of this may be an anal fistula, a condition called 'Anal Fistula' . This condition is difficult to completely cure with medication. Therefore, the best and most effective solution for this is surgery. Today we are talking about the surgery called 'Fistulotomy' for this anal fistula condition.
What is Fistulotomy?
Simply put, Fistulotomy is a surgical procedure performed to cure an anal fistula. Now let's see how an anal fistula is formed.
When an infection occurs in your anus or rectum, it can cause a painful, pus-filled lump to form. This pus will drain out after a few days, either on its own or through a small incision, leaving a path for the pus to travel. It's like a tunnel under the ground. This tunnel that forms from inside the anus to the surface of the skin is called an anal fistula.
In a fistulotomy, the surgeon (colorectal surgeon) completely opens up this tunnel. Think of it like a plastic drinking tube, cut it lengthwise and flatten it completely. When you open it up like this, the wound starts to heal from the inside out. This is the only way to completely cure this disease. However, very rarely, the condition can recur after surgery.
How to prepare before surgery?
This surgery may affect your normal routine for about two weeks, so it's important to plan ahead.
- Someone to help you: Arrange in advance for someone to drive you home after the surgery. Since the surgery will be performed under anesthesia, you will not be able to drive or go home on your own.
- Food and drink: If you are having general anesthesia, you will be asked to stop eating the night before your surgery. You may also be asked to stop drinking water about four hours before your surgery.
- Bowel cleansing: Sometimes, the doctor may advise you to have an enema to cleanse your bowels on the morning of your surgery.
Your surgeon will give you clear instructions about all of this, so be sure to ask any questions you may have.
What happens during the surgery?
After you are anesthetized, the surgeon will follow these steps:
1. First, a special device (probe) is inserted into the vagina to find exactly where it begins and ends inside the body.
2. Then, the discovered tunnel is completely cut open .
3. Finally, a gauze dressing is placed over the open wound and closed. This will absorb any blood or other fluids that may come out of the wound.
This surgery usually takes 30 minutes to an hour. The larger the hymen, the longer the surgery may take.
What are the benefits and risks of this surgery?
As with any surgery, there are benefits as well as minor risks.
| Benefits | Risks/Complications |
|---|---|
| This is the only and best way to completely cure anal fissure. | Bleeding from the wound. |
| The success rate of this surgery is very high (approximately 95%). | Wound infection. |
| It is possible to get rid of the pain and discomfort caused by the disease. | Fecal incontinence . This is very rare and is often temporary. |
Is a fistulotomy a major surgery? It is usually an outpatient procedure where you can go home the same day without having to stay in the hospital. However, since the incision can be large depending on the size of the fistula and anesthesia is used, it is not something to be taken lightly.
What should you pay attention to after surgery?
Not everyone recovers the same way. However, you will likely experience some discomfort and pain in the first few days after surgery. It may take several months for the wound to heal completely. It is important to take care of these things during this time.
- Painkillers: Take pain medication exactly as prescribed by your doctor.
- Sitz Bath: Take a sitz bath daily. This means filling a basin large enough for you to sit in with warm water and sitting in it for about 10-15 minutes. This will help reduce pain and keep the wound clean.
- Food and Drink: Drink plenty of water to avoid constipation . Also, include more fiber-rich foods (fruits, vegetables, and legumes) in your diet.
- Going to the toilet: Avoid straining when going to the toilet.
- Exercise: If you exercise daily, you may need to be patient. Your doctor may recommend that you stop doing exercises that put pressure on your lower body, especially weight lifting and deep squats, for a few months.
How do you clean yourself after going to the bathroom?
This is a problem that many people have. Since there is a wound, you need to be a little careful when cleaning it.
- After using the toilet, gently wipe with an alcohol-free baby wipe or a damp cloth.
- If possible, it would be better to take a shower or a sitz bath every time you go to the bathroom.
If you have these symptoms, see a doctor immediately.
If you experience any of the following symptoms during your recovery, contact your doctor without delay.
| Warning signs to look out for |
|---|
| Constipation lasting more than three days. |
| Excessive bleeding from the wound. |
| Having a high fever. |
| A pus-like fluid discharge from the wound or anus. |
Anal fissure is a really painful and life-threatening condition. But Fistulotomy surgery is a good solution for it. Although the recovery time is a little longer, with patience and by following the doctor's instructions exactly, you can make a full recovery. If you feel uncomfortable or worried during this time, don't be afraid to talk to your doctor about it.
Take-Home Message
- Fistulotomy surgery is the most effective and successful way to completely cure an anal fistula.
- Recovery after surgery takes some time, especially for the wound to heal completely.
- Follow your doctor's instructions carefully, especially regarding wound cleaning, diet, and exercise.
- If you develop warning signs such as excessive bleeding, fever, or pus discharge, call your doctor immediately.
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