Fistula Plug Insertion Surgery Done. Situation Not Cured. Is The Procedure Failed?

Posted on Tue, 26 Feb 2013

Question: Dear Doctor ,

i have done a fistula plug insertion surgery ( for a high anal fistula - transphenctric fistula ) from four weeks exactly and the discharge from fistula ( abscess + sometimes blood ) still persisting and continuing in same amount since surgery ( from 4 weeks ) without reduction or improving
( my surgeon did not mention that i have any other problem or Chron's disease )

so my questions are :
1- Is the procedure failed ? and when can i decide that the surgery is failed or succeeded ( after how long ? ) ?
2- Is there is pobability that the plug is extruded ? and how i know ? ( note : i visited my surgeon form two weeks ago he told me the plug in the place and it fine but for now i do not know )
3- Is there a probability that i suffer form something else ( i.e. Cancer or chron's )
( note : my surgeon done surgery for me after CHECKING my MRI and nothing mentioned about a problem in my health only a high transphenctric fistula )
waiting for your reply

thanks in advance

Answered by Dr. Hari Charan Perigela (1 hour later)

Hi

As per your query,You have undergone Fistula plug insertion surgery four weeks back.
You do not have any other problem or Crohn's disease.

This is one of the procedures adopted for high Fistula in ano as it avoids injury to the sphincter muscle.

I will answer your queries point wise.

1.Just after 4 weeks,it can't be decided that the surgery has failed or not.As per literature,you should visit your Doctor regularly for 12 months.

2.Its very rare that the Plug can be extruded.It cannot be known by yourself.Only a Qualified doctor can examine your procedure site and confirm its presence.

3.As your pre operative investigations were normal apart from Fistula in Ano,there is no chance of another disease.

But,some amount of bleeding and discharge from the Anal area is to be expected and is normal .Excessive discharge has to be managed by the treating doctor.

You have to take few precautions like Eating XXXXXXX leafy vegetables,fresh fruits,Avoid spicy foods and excess alchohol.

You can take a Broad spectrum antibiotic which contains Ornidazole and also Anti inflammatory drugs.You should take stool softeners also.

I request you to please wait for few more weeks and Consult your Doctor regularly.

Wish you good health and speedy recovery

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hari Charan Perigela (14 hours later)

Dear Dr XXXXXXX ,

Just today after i have removed a gauze ( to change it with new one to absorb discharge from fistula ) i have seen
A small piece of blue color stitches ( about 2 cm length )in the gauze !!

Is it normal for the stitch to fall from fistula with plug ? I think my surgeon told me it is dissolvable kind ?

Is it required to go to my surgeon for checking ?

Thanks a lot in advance

Regards

XXXXXXX

Answered by Dr. Hari Charan Perigela (6 hours later)

Hi.

The blue coloured stitches that have been used to fix the plug most probably got absorbed/dissolved and came out in the dressing. It is normal.

Nothing to worry.

Regards

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Above answer was peer-reviewed by : Dr. Prasad