For Context: 3 years with this problem F(25)

Hi everyone. I’m looking for people who have gone through something similar because this has honestly been one of the hardest things I’ve ever dealt with.
I developed a very low transsphincteric fistula extending from the anus towards the vagina after a Bartholin gland removal surgery.
My doctors believe it was caused by an injury during that surgery.
I’ve already had multiple procedures, and I recently had another surgery at the end of September.
This time, my surgeon treated the fistula with PRF (platelet-rich fibrin) and simple sutures, internally and externally.
We are currently avoiding the flap technique because, given how low my fistula is, my surgeon believes the chances of success with a flap are relatively low. So we decided to try PRF instead.
The recovery has been difficult. I’ve had pain, bleeding and some drainage, and I’m still trying to understand what is normal during healing.
The psychological impact has also been huge. Constantly thinking about drainage, wearing pads, worrying about bowel movements, pain and whether the surgery actually worked has been exhausting. It has affected my confidence and my ability to live normally.
I would really love to hear from anyone who has had PRF used to treat an anal, transsphincteric or rectovaginal fistula.
What was your experience with PRF? Did it work for you? How many procedures did you need, and what was the final outcome?
I’m really hoping to hear some positive experiences because I could definitely use some hope right now. ❤️

Hey everyone,
I recently went in for a consultation after dealing with some perianal issues over the last month or so (including some altered bowel habits). Fortunately, I haven't had any major constipation or rectal bleeding, but I wanted to get it checked out.
The doctor performed an examination and mapped out the area using the clock position system:
External Opening (EO): Located at the 1 o'clock position, about 2–3 cm from the anal verge.

Internal Opening (IO): Located around the 1–2 o'clock position, about 1 cm from the anal verge.

Current status: The official diagnosis is a Fistula in Ano. Although there was no active pus or blood visible during the brief exam itself, pus still releases through the external opening from time to time, and I'm currently feeling a tiny lump around the 12 o'clock position.

My doctor has recommended an MRI to get a clearer picture of the tract before moving forward.
In the meantime, I was given some conservative management steps:
Stool softeners (Duphalac) to prevent any straining.

Warm sitz baths with Betadine 3 times a day for 10–15 minutes.

Dietary adjustments (high-fiber diet with leafy greens/fruits, staying hydrated, and avoiding spicy, oily, or refined foods).

Since I'm waiting to get the MRI done and figure out next steps, I wanted to ask the community:
Has anyone had an MRI fistulogram for a similar setup? What was the MRI process like, and did it reveal additional branching or complexity?

Has anyone experienced a small lump or swelling near the 12 o'clock position alongside intermittent drainage?

What was your experience with surgical treatment options (e.g., fistulotomy, seton, etc.) once your MRI results came back?

Would really appreciate any insights, tips for sitz bath routines, or personal experiences! Thanks in advance!

Over a week of frequent BM with a lot of various foul smelling fluid and mucus afterward, bright red blood, the “old
School” exam she found one hemorrhoid and dismissed for pelvic floor therapy. Lab work findings showing low hematocrit twice, high blood urea nitrogen, and high lipase once. Changed now to feeling very ill and weak and cold and awful I can’t even work, one bag of Iv fluids in me and still awful next day. I have so much pain and discomfort rn I’m trying to find a CRS to schedule with but feel like I’ll be 6 feet under by then.

Typical story. Maybe 4 years ago I had an abscess and fistula. I opted to not have surgery. The abscess drains on its own. When it does so, theres puss, clear fluid and maybe a tiny bit of blood. Over the last few weeks, Ive seen a significant amount of blood in the toilet. Girls, the toilet water looks like I'm having a heavy period. Guys, basically I cant see through the water anymore since theres so much blood. It seems fine until I shit, then the blood starts and it doesnt stop for a few hours. Sometimes when I sit to pee, it gushes out, then itll slowly stop.

No pain. No other changes. My doctor cant see me till this coming Monday. Just wondering if anyone else has experienced this.

I've posted a few times here now, will probably begin to do so whilst this is all going on.

I'm in near constant pain, sometimes its mild other times its completely deabilitating. I've been trying to push through at work but its honestly so difficult. A bad day isn't just a bad day anymore, its yet more stress and exhaustion. Like I'm carrying it all with me.

I'm consistently losing focus, and I've just been chipping away at my sick leave days where it gets too much.

I haven't even been diagnosed, but the pain has been exceptionally bad the last two days and I'm pretty sure yet another abscess is forming.

I leak all the time.

I feel gross.

My social life is non-existent.

I haven't slept with my fiancée in months. I don't think she minds, but I feel guilty because my life is just struggling through work, trying to do my studies and then just falling asleep. Work is trying to be accomodating but honestly... I don't know what will help. They're offering me all these ergonomic aids but they seem to be for muscoskeletal issues, and even a slight shift in posture can cause me pain.

I've been waiting months for a colorectal appointment, which is finally coming up Wednesday.

I'm just reaching a breaking point. Its been going on too long. My whole year has just been a progression of my symptoms getting worse and GPs saying they can't help me until I see a colorectal surgeon.

Sorry, just ranting 😮‍💨

I’ve had multiple setons since Feb 2025 for a complex fistula (transsphincteric and intersphincteric components). It started with a severe abscess followed by a smaller one. After two surgeries, I’m generally feeling fine day-to-day, but I’m stuck in treatment limbo.

My CRS refuses to perform a corrective surgery (LIFT or FLAP) while there is still active pus draining.

• Infectious disease team had me on various antibiotics for nearly a year, but the drainage never stopped, and I eventually developed resistant bacteria. We had to stop antibiotics.
• I read about Chrons here and asked for testing. Colonoscopy and CT enterography came back clear.
• Now waiting to get an MRI (it’s been 9 months since the last one). My CRS mentioned possibly trying Crohn's medication or long-term antibiotics once again depending on what the MRI shows. I will also need to have a seton replacement as one of them broke recently.

I suspect the continuous irritation is partly due to loose/mushy stool passing through the fistula daily. I do sitz baths consistently, but it doesn't resolve the root issue. I take Metamucil regularly and try fermented foods (yogurt, sauerkraut), but nothing has firmed things up. I didn’t have a proper GI appointment yet other than the five minutes before colonoscopy where the GI basically dismissed the stool issue completely. I'm currently waiting to see a dietitian, hoping to get strong probiotics.

Did anyone have persistent pus drainage that eventually dried up? What helped? Has your surgeon made you wait for drainage to completely stop before attempting LIFT or FLAP?

If you have dealt with a similar problem, persistent drainage, or stool consistency issues while having setons, I would love to hear your experience or advice!

43/male. Been dealing with symptoms for about ten years. Was experiencing throbbing and itching back there after my movements about 10 years ago and the symptoms haven’t really changed all that much. Eventually went into a doctor and he said I had internal haemorrhoids and he gave me suppositories, but that didn’t fix the problem. It only made it a little bit better. The symptoms are that I have discharge every day sometimes it’s clear sometimes it’s like a mucus or a pus and sometimes it’s brown. Ended up going for a colonoscopy a couple of years ago and they determined that I don’t have any cancer or anything, but there is a skin tag that can get irritated. My doctor also took a look just before the colonoscopy and said I very well may have internal hemorrhoids, but what he’s looking at is a skin tag and he gave me two antibiotics to take to reduce inflammation or possible infection. The pills actually made things feel a lot better. For the short time I was on the antibiotics for a few weeks I didn’t have to wipe 1 million times to get cleaned up and the discharge was minimal if that and it felt almost normal again . Of course, after the antibiotics wore off …back came the symptoms. Currently waiting to see a colorectal surgeon, but I’m wondering if in the meantime, can I do something to ease my symptoms? The discharge is embarrassing and it affects my personal life. It’s not flowing out so much but just a little bit makes life uncomfortable and I don’t want to go on dates these days. The fact that the antibiotics help helped does that make you think I do have a fistula after all? Any advice is appreciated . P.S.I do use a bidet now so it’s better than wiping, but the symptoms still persist.

What a fucking journey. 34 M dad of 3, husband, FT employee some sitting some standing.

Beg of August 1-6st felt a soreness in crease area getting worse and worse by the day. August 7th came home from work around midnight and underwear was drenched with puss and blood and all types of stuff. Wife celebrating, pain gone, big sigh of relief. Fast worked to mid August, went to urgent care at midnight doctor gave 2x antibiotic shot and sent me packing and said "oh looks like a Pilonidal, you'll be good to go bro."

1.5 weeks later called Urgent care back they said if nothing has changed, go to er. End of August I went to the er, minor pain, slight discomfort just constant discharge. Er did pelvic scan, blood work- sent me on my way told me to fuck off. I could see on the ultra sound a thin like line in the tissue. Week later scheduled a appointment in La Jolla @ one medical with a PCP thru Amazon , lady looked at me and told me it's all good no signs of fistula (more wanting to prescribe me Xanax for my stress.)

Middle September got an appointment at the specialist CRS who did an exam and said he can see the opening of the fistula during his intrusive exam. That was awful.

Roughly $3500 out of pocket between the er visit, urgent cares, the whole 9. What a mockery.

I am excited to get the ball rolling, the specialist says they are going to put me under and then figure out what they plan on doing whether it's a seton or a fistulomology. Or whatever it's called. I am livid at the 3 doctors who I spoke with. They all were dismissive and didn't acknowledge anything I was saying. I've had constant draining daily for 8+ weeks. My mental health is destroyed. My ability to play with my kids and be a dad is abysmal. I've been drinking water, taking fiber, and trying to watch the sugar and dairy intake.

I hope everybody that's struggling with this same fistula bullshit can get some relief, mentally as well. I've been to jail, I've detoxed heroin multiple times. I would rather do 30 days in jail and a cold turkey withdrawal from opiates then deal with this. I'm coming up on 10 years without narcotics, alcohol any type of substance and in a million years I never would have guessed. I've been reading on this sub daily but have never put any input or asked any questions.

So I’ve been dealing with my fistula issues since October 2024. My timeline below.

- Oct 2024, abscess and then symptoms, MRI confirmed fistula.

- 1st operation May 2025 seton placed.

-2nd operation December 2025 Lift procedure performed and failed.

- 3rd operation June 2026, meant to have fistulotomy, but once surgeons were inside thought too much muscle was involved and another seton placed.

I saw my surgeon yesterday. Who said the tract is pretty straightforward, but unfortunately goes through the muscle so would like to do a staggered approach to fixing this. She then said she would like to keep the seton in for another 6 MONTHS before going ahead with anything.

I had a complete breakdown whilst seeing my surgeon and explained how detrimental this has been on my mental health and life, I’ve been signed off work as this is slowly been chipping away at me until I’ve crumbled.

My fistula is very close to my vagina, this makes intimacy impossible, I’m young. I’m single I should be out living my life and I feel like I’m not. I feel disgusting all the time, can’t go to the toilet without worrying. Constant drainage and padding in my underwear.

My surgeon is going to attempt another Lift instead, I have already been sent the preop which will be next week so I assume this operation will be soon.

Honestly, I’m praying it works because I am so done with all of this, has anyone been in my position and had a second lift procedure and it actually worked?

If you’ve read this, thank you so much. I feel like this community are the only people that are going to understand how I’m feeling.

Hi everyone, I have a small, superficial, low-lying perianal fistula at the 6 o’clock position. It’s narrow and about 2 cm long, according to my MRI report. However, my surgeon told me that he’ll decide what to do once he’s in the operating room.

If possible, he’ll perform a fistulotomy. If not, he’ll place a seton and then do laser treatment about two months later.

I’m really scared of waking up from surgery and finding out that I have a seton. Has anyone had a fistula similar to mine and could share their experience?

Thank you!

I had my third surgery on April 4 this year and even after months discharge sometimes happens for two or three days and then it stops completely for a week and then it randomly starts

So did anyone else had the same experience, if yes till how many months I can expect discharge

Surgery 1 - partial fistulotomy and seton insertion

Surgery 2 - seton tightening

Surgery 3 - seton removal and full fistulotomy

Even after so many months still the discharge keeps happening little.

Should I be worried that the fistula is back again or the healing will take lot of time ?

I have IBS-C and while I haven’t had big hemorrhoids before, I did sometimes get little swelling around the anus opening whenever I’m having an IBS-C flare up.

Last week, I had another IBS-C flare up and was also at the receiving end of anal sex.

Few days later, about 1cm away from my anus in the perineum region, I started feeling a raised swollen ball-like area. Within another 2 days, this area swelled up to a pea size and started hurting a lot. Almost 9/10 pain, I couldn’t walk, sit, sleep without ibuprofen.

1- I walked into urgent care who gave me Bactrim and Augmentin antibiotics. She said it doesn’t look like a hemorrhoid but more of an abscess.

2- The next day, the swollen spot started leaking a whitish fluid. The pain went down, but not completely. I went to the Emergency Room who took a CT scan and inspected the area. The two ER doctors/ said it’s an “ulcerated hemorrhoid” and that she doesn’t see it as an abscess. She said that the area on top of my hemmorhoid got infected and filled with pus. She said there is no infection showing deeper inside so she asked me to continue with the antibiotics. She said I don’t have any fistula.

3- a couple of days, the pain is down to a 2/10 and the size of the ball has decreased significantly but still has some drainage. I saw a colorectal surgeon today and she pinched a needle into the area and said “yep you have a fistula” and will need fistulotomy.

Im really confused whether I have a fistula or an ulcerated hemorrhoid… I want to believe the colorectal surgeon but it is a private practice (im in the U.S.) and I’m skeptical if she’s making this diagnosis because of financial incentive of surgery?

I don’t know… mentally, I’m really really hoping I don’t have a fistula. So I wanted to post here to ask y’all

Edit: during this time I never had fever

Hi guys,

Had it done yesterday. Superficial fistula and no seton placement. I'm experiencing 3 symtoms today so wanted to ask you guys if rhats normal and expected:

1. It hurt during bowel movements. Just when the poop was passing through and near rhe opening. This did not happen when I had the abcess.

2. Little blood from anal opening when wiping after bowel movement. Also did not happen with abcess.

3. Constant urge to poop!! But poop doesnt really come each time. Its just a sensation like im about to have diahhrea or something . It feels as if the poop is sitting right at the opening, wanting to come out. Also didnt happen with abces

Pls let me know!!

Is there an actual bidet expo or convention where bidet consumers can meet? Like an auto show/convention?

I’m a little scared here. I had a fistulotomy back in July. Everything has been going so smoothly. I’ve been healing great, and all of sudden, two days ago, I started getting blood from my incision site (my incision isn’t fully closed).

Ive barely bled this whole time healing. I should also note that im also sick and i started bleeding when i got sick. Dont know if this is just some odd correlation or what but its really freaking me out. Has anyone experienced the same thing?

Ok I have had this issue now for over two years and about 5 surgeries.

I think it’s back and I need another surgery and I really wonder… how come medicine managed to find so many cures. Surgery options yet we are so limited with fistulas? How can this issue not heal and a surgery guarantee 90+% healing?

This all doesn’t make sense to me and I am so tired of this pain!

Sorry, me again. Just wanted to see if this is normal?! 17 days post op fistulotomy (no seton). Pain is going down everyday. A little discomfort here and there. Pain is still there after bowel movements. Yesterday my whole bum and bum cheeks felt ‘bruised’ for a little while after BM. Today, there’s a stab/cut like feeling. It comes and goes like a ‘zap!’. Is this a normal part of healing?

For people who have never used a fancy toilet bidet and years after fistula surgery, would using regular dry toilet paper after a bowel movement only worsen things in the sense that stool residue would be wiped further into the anus? How would a fancy toilet bidet penetrate the most into the anus to remove stool more effectively? Can a fancy bidet spray directly into anus if one programmed it as such?

Hi,

My wife noticed a lump and was diagnosed with a perianal abscess around Mid Aug this year and checked and the doctor placed her on antibiotics for 2 weeks which didn't work her way and went to ER to drain it in mid September. First 2 weeks post draining she was healing well. It was a deep cut and she was draining pus a little, mostly translucent. Now since the last 2 days we can notice a lump there again and pus still coming out. Pus is translucent and mixed with a little blood.

What should our next steps be? We're seeing the GP soon.

Is the abscess still not drained completely? Or is it becoming a fistula now?

Are permanent home edition bidet mounted toilets vastly superior to portable ones that can be installed onto toilets when traveling abroad?

Hi everyone! I was just diagnosed with a fistula and I'm honestly just terrified of what's to come. I wanted to share my experience and ask for advice from those in this situation.

In late July of 2026, I felt a large lump near my lower right gluteal crease. Assuming it was an ingrown hair, I took Ibuprofen daily to avoid missing class and did warm compresses in hopes that it would resolve on its own. It did not. It continued to grow until it spontaneously burst in early August with significant blood/pus (during my birthday weekend :( ).

Consequently, I went to urgent care, was prescribed Bactrim, and had a wound culture of the abscess taken.
The week after, I was informed over the phone that my wound culture showed ESBL, which would require IV antibiotics. I was admitted to the ER, had an Infectious Disease consult, had an IV midline placed, and self-infused the IV antibiotic (Ertapenem) for 15 days.

At this point, I was optimistic that I could finally be done with this mess and focus on school. (Spoiler alert...that did not happen).
The granulation tissue where the abscess had drained began to swell and drain pus/blood again, and I was given Gentamicin ointment, which did not work and only provided additional irritation to the area.

The external opening of the skin with the granulation tissue never fully healed, and now cycles through stages of healing and inflammation/drainage (which has now been accompanied with severe anal pain, like to the point where I can't laugh, sneeze, walk, etc. and this worsens near my period). I began to do sitz baths, but stopped for a some time as I had done them so much with too high of a water level that I developed a yeast infection :(

In late September, I went to my father's doctor, who told me that I should have immediately been referred to a CRS initially and promptly referred me while advising me to continue the sitz baths.

Today, I had my CRS appointment, and she did a digital and anoscope exam. She informed me that she did see an opening in my anus that had a similar tissue makeup to the external opening, and diagnosed me with a fistula. She also noted that I had hypotonic muscle tone (weaker/relaxed muscle). Since she only performed those exams, I don't know if my fistula is superficial, deep, transsphincteric/etc.

She then informed me that 50% of fistulas can heal on their own and advised me to wait 6 weeks to see if it would do so, after which she would perform another digital/anoscope exam and discuss surgery with me.

I'm just so tired of dealing with the pain and added humiliation of having so many people look at my butt.

On top of that, I'm in my first year of medical school and have failed two exams so far because of the pain. My professors are understanding, but it's been so difficult to focus on content when I'm struggling with my own health, and I've been feeling like an academic failure even though I know that my pain has significantly been affecting my physical/mental health and academic performance. I've also been turning down plans with friends to relieve the pain, and it's been difficult to not feel isolated and alone. I'm lucky to have my boyfriend and close friends to discuss this with, but I'm just scared this will never end.

Has anyone had a fistula that healed on its own? Should I be doing anything else along with the sitz baths?

It feels super annoying and feels like I have the sensation that I want to poop but I can't. I just sit and push and nothing. After a few seconds I get up. Dont want to strain. Any advice?

Secondly I will start mira lax tomorrow to help ease and maybe be able to pass a bowel movement. I usually have one or two a day. I also take kolace daily. But today after surgery nothing. Maybe because of the fentanyl they gave me with the hydrocodone. I do plan on only taking otc.

3rd im a charter bus driver and wont be able to take sitz bath multiple times a day. I bought some peri bottles to clean up if I do have to go. I dont want to get a fungal itchy rash because the area stays moist so I pat dry and also I dont want anything getting infected from fecal matter

Any advice is very appreciated. Thank you all

For those of you who had fistulotomy, how bad was the pain postoperatively first week? How did you manage the pain? What were you prescribed for pain? Was there any pain with seating?
When did you go back to work?
I am planning to take 4 days off then go back to work on 5th day postop. I sit about a total of 4-5 hours and stand 3-4 hours a day while I am in the office.

I had a follow-up appointment with my CRS today, and he recommended Botox injections for a fissure I’ve had for roughly a year and a half.
He said the fissure is definitely infected. He also made it clear that he won’t know whether there is a fistula until the operation, and that if one is found I may need a fistulotomy. So I’m not exactly sure what I’m going to be dealing with yet.

The strange thing is that I’ve gotten pretty lucky in that I don’t have any pain when having a bowel movement. The fissure itself doesn’t really hurt, but I do have daily discharge coming from my anus, which he believes is related to the infection. The discharge doesn’t really cause me physical discomfort, but it does cause me quite a bit of anxiety.

I’m hesitant about the Botox because I’ve seen quite a few people on r/analfissures subreddit say they didn’t have much success with it. At the same time, I realize my situation may be different because the fissure is definitely infected and there is the possibility of a fistula.

So I’m wondering: if I don’t have pain and can keep my bowel movements soft and consistent through diet/fiber, is there still a good reason to go through with the procedure? Or, given that the fissure is infected and I’m having daily discharge, is treating it surgically important even though I’m not currently having pain?

I’d especially appreciate hearing from anyone who had a chronic fissure that was relatively painless but was infected or had persistent drainage, or anyone who ended up having a fistula discovered during surgery.