Fistula surgery recovery takes time. After this type of outpatient surgery, a person will need rest before they can return to their usual activities.
While a fistula can happen anywhere in the body, most fistula surgeries remove fistulas in the anus and rectum.
Fistula surgery removes an abnormal tissue connection and sometimes the area surrounding it. The most common types of fistula surgery are fistulotomy, which is an outpatient procedure to remove only the fistula, and fistulectomy, which is a more complex surgery that removes the entire area the fistula affects.
A fistula is a tunnel or clump of tissue that affects two structures in the body. It can affect most areas of the body, but one of the most common locations is the anus. This can affect function, cause pain and constipation, or lead to infections. If the outer hole of the fistula closes, it may create a swollen, pus-filled, painful abscess.
Fistulas often happen following surgery on the anus or rectum. An infection that forms an abscess may also lead to a fistula, especially after surgery. Cancer, foreign bodies in the rectum, radiation therapy, and inflammatory bowel disease may also increase the risk.
No medication or lifestyle changes can cure a fistula. Surgery is usually necessary.
Surgical treatment is highly effective at managing fistulas. The right surgery depends on the type of fistula a person has.
- Seton drain placement: A seton drain can help drain an infection. This may reduce the risk of developing a fistula or, if someone already has a fistula, delay the need for more invasive surgery.
- Fistulotomy: A fistulotomy is a procedure that cuts the connected tissue that forms the fistula. A doctor can often do it on an outpatient basis, and a person does not need to stay in the hospital.
- Fistulectomy: Fistulectomy removes the tract of tissue that contains the fistula, as well as the fistula itself, rather than just cutting the connection between the two tracts. It poses
a higher riskof complications because a doctor has to cut into the affected organs — usually the anus — not just the band of tissue connecting the organs.
The recovery time for fistula surgery depends on the type of surgery a person has, their overall health, whether they have an infection, and the skill of the surgeon. Success rates also vary and can affect how soon a person feels better.
For example, an older 2013 study of people who had a fistulotomy found an overall success rate of
With a fistulotomy, a person will
A fistulectomy has a longer recovery time because a person needs general anesthesia. This means they will need to have the procedure in the hospital and may need to stay overnight for monitoring. There is a higher risk of infection and incontinence with this type of surgery. A person may need several weeks to feel better and may need to stay home from work for a few days.
After a person fully recovers, in most cases, the fistula heals, and a person will not have lingering issues such as incontinence. But if there are surgical complications, a person may need additional treatment or more surgery.
Some strategies to reduce the risk of pain, infection, and other issues include the following:
- Talk with the surgeon about recovery time and other precautions.
- Rest after the procedure, especially if it involved anesthesia.
- Ask a doctor if a less-invasive procedure, such as a fistulotomy, may be an alternative to a fistulectomy.
- Ask a doctor about their experience performing fistula surgeries and the rate of complications.
A seton drain is a drain that can help heal anal fistulas. Some fistula surgeries involve placing such a drain to help remove pus and other fluids from infection and heal the fistula.
A person may have spotting or bleeding for 1–2 days after the procedure, and pain for 1–2 weeks. In most cases, a person can return to work the day following the procedure if they feel well.
There is a small risk of incontinence, infection, and other complications. People who notice pain, bleeding, or a bad smell should see a doctor right away. Because constipation increases the risk of complications, it is important to eat plenty of fiber and remain hydrated.
An older 2012 study of 53 seton drain recipients found a
A seton drain may be permanent or temporary.
If a person gets a seton as part of a fistulotomy or as a standalone surgery, scar tissue may form around the seton. A surgeon may need to trim down this scar tissue or perform a second procedure.
Fistulectomy and fistulotomy may also cause scarring. In most cases, the scars are not a problem, but some people notice pain or tenderness at the site of a scar. A person should talk with a doctor if the scar tissue is uncomfortable or if they notice a large mass at the surgical site.
The wound from fistula surgery will continue to drain after surgery, especially if a person has a seton drain. This drainage is important and helps remove the infection from the body.
Ask a doctor about proper wound care. They may recommend applying sterile dressings, rinsing the wound, or applying cream to the wound. Do not pick at the wound or put anything on it without first talking with a doctor.
Here are a few tips to help with recovery from fistula surgery:
- Avoid sexual intercourse, or inserting anything into the rectum or vagina, until a doctor says it is safe.
- Follow up with a doctor after the procedure. Most providers schedule a visit a few weeks after surgery to ensure healing is going well.
- Drink plenty of water to reduce the risk of constipation and keep stools soft.
- Ask a doctor when to go to the hospital or follow up. In most cases, a fever, increased bleeding, increased pain, or pus from the wound may warn of an infection.
- Avoid constipation by eating high-fiber foods or taking a stool softener.
A fistula can be painful and scary and may affect daily life, especially if a person has difficulty using the bathroom. It is important to work with a surgeon who has significant experience treating fistulas and to ask questions about the best surgical treatment options for a person’s health goals.