A fistula is an abnormal hollow tube that forms and links two organs of the body. I was originally told I had a perineal sinus tract ( an abnormal tube that is closed at one end) but they later found it to be a fairly long and wide fistula.
I have an unusual fistula, because I don’t have a rectum but have a fistula there that connects to the top part of my lady bits near my cervix. It is unusual because when I google it they don’t seem to be very popular AFTER rectum removal. A fistula connecting the two is called a recto/vaginal fistula but mine doesn’t come under that heading. My surgeon called it perineal/vaginal fistula, and although it is awful to live with ( especially 3 years down the line and two failed surgeries) if I still had my bowel then bowel contents would come out of my female parts, so there are some things to be thankful for.
This is a ( very) basic diagram where my fistula is in red so you can get the idea what is happening with me.
Needless to say, I leak out of both bits more or less constantly. It seems to come in waves of severity. I think the fistula kind of drains, then fills up then drains and so on. Sometimes it leaks just yellow fluid, others it can leak the fluid with blood or/ and pus ( grim, believe me I know how it sounds, but I also know how it feels) If they don’t drain properly or close up temporarily then an abscess can form and you can become quite unwell. A surgical thread called a Seton is placed into the fistula to keep it open and draining and sometimes if they are tightened regularly then the fistula MAY heal. ( Although if you speak to people who have this they might not agree that a fistula can be cured this way)
They are notoriously difficult to get rid of and my upcoming flap surgery in October is the last resort really. There are no promises that it will work and I can only hope that it gets rid of the damn thing. The flap surgery I was having for the perineal sinus is pretty much the same, I will be having my buttock muscle used to fill the dead space in my pelvis after the fistula has been removed. So a plastic surgeon does the difficult bit this time. I asked him what would happen if it didn’t “take” the flap graft and he said ” You have another one” hmmmm.
I am very scared of the recovery for this operation and just hope it goes as smoothly as possible. If anyone has had this type of surgery I would be grateful for any tips.
I often mention my stomal fistula on here which I have had since the original surgery. This is where an abnormal link occurs from somewhere in my small bowel to the skin surface just at the base of the stoma. This time my poo does come out onto my skin around the stoma. Now this is quite difficult to manage and live with too. Apart from the fact that my skin has to be protected, I find it hard to cut my base plate to exactly the right shape AND to place it in the correct place. I have tried quite a few things and know in my heart that I will be having surgery to get rid of that too. Fistulas are not very common with ulcerative colitis and are more usual in Crohns disease, so I often wonder if I had Crohns of the large bowel, as I was told it was once ,then they said Crohns colitis then back again until it was settled on indeterminate colitis. Of course as with most things fistula can develop from other reasons too.
As you can see quite clearly, my fistula looks like a mini stoma and that connects somewhere inside along the length of the small bowel. It is tiring to look after two fistulas and I would like to be able to get on with my life without them. My stoma is great in every other way so surgery comes with worries too because I have no other problems with it at all so could I be causing more issues that isn’t there now… decisions decisions.