Fistula seton stitch, advice needed

[Normanski]

Hi everyone,

I'm new to this forum, 24 y/o male and on Saturday I had a seton stitch inserted under GA. I have a follow up appointment booked in for a few months time but unfortunately I didn't get to speak to my doctor after the surgery, I have some questions in the meantime that are really bugging me, would be great if anyone could help because I feel like I've been left in the dark (NHS privately funded) by my doctor/surgeon

1) My follow up is in 2 months time, will this be when the seton is removed?
2) How do I know if the fistula is healing well or not?
3) How is the seton removed? Do I have to go under surgery again or is it a simple cut and pull out?
4) Will the pain and discomfort subside? It's been a few days since the surgery but everytime I move I feel lots of pain in the seton/fistula area
5) If the fistula hasn't healed by the time of my follow up can I request to have the seton removed anyway? I don't want to have this seton in for much longer and didn't even notice it beforehand but was advised by the doctor to go through with this procedure that i'm kinda regretting
6) How can I make sure it heals properly?

Any answers would be greatly appreciated and I'm happy to share my story so far if anyone is interested.

Thanks in advance

 

[Polar bear]

@normanski

1) My follow up is in 2 months time, will this be when the seton is removed?

It depends, if you still have an infection it is not a good idea to have the
seton removed.
2) How do I know if the fistula is healing well or not?

With the seton, the fistula will not heal. The purpose of the seton is to
keep the hole open, this hopefully will prevent abscess from forming. You
should see an improvement, for example the area is not inflamed and less
painful. .
3) How is the seton removed? Do I have to go under surgery again or is it a
simple cut and pull out?

I used to have two setons. After 18months in, it broke apart, so I just pull
it out.
4) Will the pain and discomfort subside? It's been a few days since the
surgery but everytime I move I feel lots of pain in the seton/fistula area

It is different for everyone. I had a hard time with mine. It took about 6
months for me to feel any relief. Others are lucky, I have read that some
have experience discomfort for only a couple of weeks.
5) If the fistula hasn't healed by the time of my follow up can I request to have the seton removed anyway? I don't want to have this seton in for much longer and didn't even notice it beforehand but was advised by the doctor to go through with this procedure that i'm kinda regretting.

Again, the fistula will not heal or close if you have a seton. The purpose of
the seton is to keep the hole open so pus/infections can drain. You dont
like the hole to heal over if you still have infection, otherwise you
will have another abscess. Your doctor should be able to evaluate your
condition if you dont have any infection anymore.

6) How can I make sure it heals properly?

Keep it clean, sitz bath. In my case, I have observed that some food made my fistula more painful. Example of food that I avoided: coffee, corn, and pork. Again everyone is different, you may have to experiment if there is any food that cause more pain.

I hope you find relief soon.

 

[Normanski]

Hi Polar Bear - thank you for answering my questions, i've ordered a sitz bath so hopefully that helps with the healing process.

8 days post op but unfortunately still relying on painkillers, without them the pain is unbearable, what is likely causing the pain, the seton or the infection? I found out that I have a draining seton, it's very loose and keeps moving about, could this be causing the pain and is it unusual for the seton to be so loose and mobile? The knot keeps ending up in the fistula wound opening itself which absolutely kills when there and even worse to move!!!

In all seriousness what would happen if i just cut the damn thing with scissors and pulled it out? I only had this operation because my doctor recommended it, before the operation the fistula hadn't caused me any problems or pain at any point, it was just, there....

How are you healing/treating your fistula?

 

[Polar bear]

@normanski, the seton is there for the drainage to speed up the infection healing process. Then was a time even if I have my seton, the drainage was blocked, I have to move the seton around to unclog the buildup. If there is a builup of pus it will find an outlet somewhere and may cause more fistulas. The seton is there to avoid you from abscessing. I personally would have preferred a more loose seton to easily move it around. Even though mine is not a cutting seton, it was tied so close to the skin that moving it around is a challenge. I wrap the knot in one of those gauzes so it does not get into the hole. Please dont just cut it without your doctors instructions. It was there for a reason. I had a hard time with my setons , but the abscess pain for me is much more unbearable. Give the setons a chance to do its work. Make sure you are infection free before you cut it. I hope you find relief soon.

 

[Normanski]

Ouch sorry to hear that, I can imagine a tighter seton causing more pain, how long have you had yours in for? That sounds like a good idea re the gauzes, the sitz baths have really helped so thanks for the recommendation I can feel the tract going from the wound to opening and it feels quite hard and thick, yet the drainage is minimal, is this a sign the infection is still at large? Thanks for your help, Polar

 

[Polar bear]

@normanski, everyone is different but I think if you can still feel a thickness/hardness there is still infection. My abscess started as a hard lump, and it really took a while for it to subside even with the seton. I had my setons (had 2 at the same time) for 18 months till it breaks on its own. Your doctor should be able to give you more information if you are on the right path to healing. I hope you find relief soon.

 

[lgpcarter]

Hi everyone,

I'm new to this forum, 24 y/o male and on Saturday I had a seton stitch inserted under GA. I have a follow up appointment booked in for a few months time but unfortunately I didn't get to speak to my doctor after the surgery, I have some questions in the meantime that are really bugging me, would be great if anyone could help because I feel like I've been left in the dark (NHS privately funded) by my doctor/surgeon

1) My follow up is in 2 months time, will this be when the seton is removed?

Likely not. I had mine for 8 months. 2 inserted at same time.
2) How do I know if the fistula is healing well or not?

You’ll get less pain and drainage.


3) How is the seton removed? Do I have to go under surgery again or is it a simple cut and pull out? Surgeon cut mine. Didn’t hurt when he pulled it out.

4) Will the pain and discomfort subside? It's been a few days since the surgery but everytime I move I feel lots of pain in the seton/fistula area

It should! Mine sucked for 2 weeks and then got better. They cut one tract open at the same time, so I had a lot going on. Sure baths helped. Stool softeners too.

5) If the fistula hasn't healed by the time of my follow up can I request to have the seton removed anyway? I don't want to have this seton in for much longer and didn't even notice it beforehand but was advised by the doctor to go through with this procedure that i'm kinda regretting

You could, but hopefully you can hang in there. I got used to mine. You really don’t want to have to go through having new ones inserted.


6) How can I make sure it heals properly? Sitz baths, I was on flagyl for a couple weeks. I used (and still do) gauze that I shove in my crack to absorb drainage. Helps keep skin happier and me feeling more comfortable.

Doing better now?

 

[cmack]

Hi Normanski,

I hope you are doing well. It sounds like you are getting things figured out. I agree that you shouldn't try to remove the seton yourself, it could be very dangerous. The whole reason for it is the drainage of fluids to prevent further fistulas/abscesses, as was described above.

Give us a shout and bring us up to speed with how you are doing if you are feeling up to it.


Cheers,

Chris