Fistulotomy

What is a fistulotomy?

A fistulotomy is surgery for anal fistulas. Anal fistulas often happen when you have an infection near your anus or rectum. The infection causes painful pus-filled bumps. When pus drains away, it causes a fistula. This is a small channel or tunnel that runs from the infected area to the inside of your anus. In a fistulotomy, a colorectal surgeon opens the channel or tunnel so the fistula can heal. This procedure can cure an anal fistula. But the condition may come back after surgery.

How should I prepare for a fistulotomy?

A fistulotomy may affect your daily routine for up to two weeks. Everyone’s situation is different. Ask your surgeon when you may be able to return to work or how long you may need help at home while you recover.

You should plan on having someone to take you home after surgery. That’s because you’ll receive local or general anesthesia so you won’t feel pain during surgery. If you receive general anesthesia, your surgeon may tell you to stop eating the night before your surgery and to stop drinking fluids four hours before. They may ask you to do an enema on the morning of your surgery.

What happens during a fistulotomy?

Once you receive anesthesia, your surgeon will:

1. Insert a probe into the fistula to see where the fistula begins inside your body.
2. Cut the entire length of the fistula. (Think of a plastic straw that you cut open and flatten.)
3. Place gauze dressing over the opened fistula. The gauze absorbs any fluid or blood coming from the wound.

How long does a fistulotomy take?

This procedure may take 30 minutes up to an hour. The surgery time depends on the size of the fistula. In general, the larger the fistula, the longer the surgery.

What happens after a fistulotomy?

You’ll stay at the hospital until you recover from anesthesia. Your care team will explain what you can do to take care of the wound while it heals. For example, they may tell you when and how to change the gauze that covers the wound.

What are the benefits of a fistulotomy?

Surgery to repair an anal fistula is the only way to cure the condition. A fistulotomy is the most common surgery for anal fistulas.

How successful are fistulotomies?

This surgery has a high success rate. A recent analysis shows the procedure cured 95% of the people who had one.

What are the risks or complications of a fistulotomy?

Common complications are:

• Bleeding
• Fecal incontinence
• Surgical site infection

Is a fistulotomy a major surgery?

Fistulotomy is an outpatient procedure. However, your surgeon may make a large incision (cut) to repair the fistula, and you may receive general anesthesia.

What is the recovery time for a fistulotomy?

Everyone reacts differently to this type of surgery. You’ll probably feel uncomfortable for a few days after your surgery. But it may take several months for your surgical wound to heal. The following suggestions may help you during the first part of your recovery:

• Take pain medication as prescribed.
• Take a sitz bath.
• Drink lots of water and focus on high-fiber meals so you don’t have constipation.
• Avoid straining when you poop.
• Be patient if strenuous exercise is part of your normal daily routine. (Avoid things like deep squats or lower body strength training.) Your surgeon may recommend you take it easy for the first few months after surgery.

How painful is a fistulotomy?

Pain from a fistulotomy varies depending on the size of the incision your surgeon makes. You may feel some pain and discomfort while the surgical wound heals. Talk to your healthcare provider if you have more pain than you expected. They may prescribe medication to help manage it.

How do I wipe after a fistulotomy?

Here are some ways to take care of your anus after pooping:

• Use a baby wipe or wet wipe after you poop. Just be sure the wet wipe doesn’t contain alcohol.
• Take a shower or sit in a sitz bath after you poop.

When should I call my colorectal surgeon?

Contact your surgeon right away if you have:

• Constipation that lasts for more than three days
• Excessive bleeding
• Fever
• Pus draining from your rectum