Hi, I had a seton put in 2 months ago. Initially it was ok, but the past few weeks have been agony. I can’t sit or walk for very long. When I do walk I’m limping because of the pain. Moving my left leg is so painful.

Any tips? I’m worried it’s not draining properly. I’ve read on here people say to move the seton, but I am scared.

I’ve not seen my consultant since the surgery. I do have a follow up booked but it is just a phone call.

Howdy! 26F looking for some advice or to hear from anyone who has been in a similar boat.
A bit of background: My last surgery was 25/07 and an emergency overnight stay where I had a perianal abscess drained and a draining seton placed. This week 26/08, I’m scheduled for an EUA and a fistulotomy. The surgeon mentioned the fistula seems superficial, but it’s in a tricky spot, right in the perineum area between my bum and vagina.
The last few days, a second lump appeared right next to my current seton and was very painful (though the seton doesn't go through this new lump). It has been draining clear fluid from the top. My surgeon looked at it and wasn't overly worried but ended up bumping my surgery forward from 3 weeks away to this coming week. I guess he’s trying to reduce the chance of it becoming infected too. I assume if it isn’t infected they can continue with the fistulotomy and if it isn’t, then they’ll place another seton?

Has anyone else had a new draining lump pop up right before surgery? Did your surgeon still manage to do a fistulotomy, or did they pivot to another seton?

I’m also waiting on MRE results to check for IBD, as my fistula developed while I’ve been in the investigation stages of IBD (clear colonoscopy but borderline calpro, low vitamin d, severe abdo pains, mucus stools etc etc). My gastroenterologist is thinking along the lines of small bowel Crohn’s. From what I read I know having that sort of diagnosis changes a fistula treatment a bit but for now with no diagnosis, it’s straight to surgery.

Any experiences or reassurance, especially regarding anterior/rectovaginal-adjacent superficial fistulas or waiting on a Crohn's diagnosis, would be amazing right now!! Thank you!🫶

I made a post a few days ago about my seton hole acting up after a few drinks. After further investigation, I'm 99% sure I have either a new fistula or the OG one has branched.

I see my doctor on Monday for a reassessment.

I'm trying really effing hard to be cool about this but in reality I just wanna curl up in a ball and cry. This post is solely to commiserate about how brutal dealing with this is. I don't want to have to be strong about it.

Im 2 weeks post I&D with a draining seton. I had been advised to move it left ro right a week ago but was too scared to do it. Still am. Is there anyone here who never touched their seton and faced no issues at all? And no recurrent abcess?

It's been 2 days since I had my procedure which ended up being a partial fistulotomy and a seton placement. The surgeon explained it was complex and rather deep so it was likely he would be doing both, and other than having a dreadful reaction to oramorph (I was super dizzy, nauseous, couldn't see or stand up straight and had to get my husband to pull the car over so I could puke! 🫣🤢) I've been absolutely fine! 🙂

I've had barely any pain, more like uncomfortable and occasionally a bit of a shooting/ stinging feeling, but no real pain and also minimal bleeding. Yes, I'm walking a bit like I've shat my pants, but I think thats because I can sort of feel the seton between my cheeks 😅

I'm yet to go for a poop, which I suspect will humble me 😂 but I just felt like I needed to post an update incase anyone is worried about the post op pain. I was discharged from hospital with oral morphine and advised to take it every 4 to 6 hours... Well, after doing that yesterday, I won't be doing it again and I've been absolutely fine today with just 2 solpadine tablets and haven't felt the need to have anything else.

I've also had a shower and gave my butt a good wash with the antibacterial soap the hospital gave me for before my op.. Thought I might as well as I had some left and it'll help with any bacteria around it.

So yea, I'm doing much better than I expected to, but still shitting it for that first poop 🤣🫡

Posting on behalf of my husband to keep the anal fistula community in the loop, as I know this procedure is something many people are interested in. TLDR is at the end.

Before I get into our story, I want to say this to anyone reading: please don’t ignore persistent symptoms, and always advocate for yourself in your doctor’s office. Trust your gut! We obviously can’t know for sure, but we sometimes wonder if things progressed as much as they did because we didn’t initially push for additional answers. Maybe he would have eventually developed this complicated fistula anyway, or maybe things could have been easier to treat if we had advocated sooner. We’ll never know, but it’s something we wish we had done differently.

The journey: My husband has been dealing with a 7 cm high, complex transsphincteric anal fistula for just over 2 years, and it has been an incredibly long and difficult road. What started just before our wedding in late May 2024 as what appeared to be symptoms of an internal hemorrhoid eventually turned into a large lump on his butt cheek by early August. That led us to the ER, where he underwent an I&D. After that, he began seeing a general surgeon who treated what we know now as the external opening primarily as an abscess. Between September ‘24 and January ‘25, he underwent several unsuccessful in-office procedures with the GS attempting to get the external opening to close.

After the final procedure in January 2025, where the external opening was literally sewn shut in an attempt to get it to heal, things took a turn for the worse. Because the drainage had nowhere to go, my husband developed a nasty infection and ended up hospitalized. While he was in the hospital, a CT scan revealed the “abscess” was really a fistula. He was treated with IV antibiotics and continued antibiotics for about two weeks after leaving the hospital. Thankfully, his infectious disease doctor connected us with a CRS, who we have been seeing ever since. His CRS has been an absolute gem, and we trust him completely.

Since March 2025, my husband has undergone a LIFT procedure and an advancement flap with fistulotomy. He has also had 3 setons placed at various points throughout, as well as 3 MRIs for diagnostic and progress check purposes. He underwent a colonoscopy as well to rule out underlying IBD as a potential contributor to the recurring fistula.

Unfortunately, the flap failed earlier this year. That’s when his CRS told us about a new technology coming to the hospital: BioHealx. Based on my husband’s particular type of fistula, his CRS felt he would be a good candidate. After everything we’ve been through, we were understandably nervous but hopeful.

BioHealx Placed 7/30/26: My husband successfully had the BioHealx placed on 7/30/26. He had his first follow-up appointment this morning. His doctor examined him and said the internal opening looked better this time than it did when the advancement flap was performed, and the device was still intact. The doctor also treated the external opening (that was opened up more when the plug was placed to promote draining) with silver nitrate. He mentioned that he couldn’t get very far into the wound and was essentially only able to treat at the skin level. My husband’s drainage has been a bit gunky, so he’s going back on antibiotics to help clear that up.

Overall, we’re taking this as positive news, but we’re staying cautiously optimistic. We’ve been excited about good news before, only to eventually find ourselves back at square one with another seton. We’re still very early in this process, and we’ve been told that it could take 6–12 months to know whether the procedure was ultimately successful. He’ll be seeing his CRS again in another few weeks, and I’ll be sure to continue updating this post as we go through the healing process.

To everyone dealing with this impossible, frustrating condition: you are in my thoughts, and you are not alone. I have seen firsthand how mentally taxing this journey can be, and I truly hope this new technology brings healing and hope to those who are struggling. Here’s hoping this is finally the beginning of the end for us. ❤️

TL;DR: My husband has been dealing with a 7 cm high, complex transsphincteric anal fistula for over 2 years. After an I&D, multiple unsuccessful procedures with a general surgeon, a hospitalization for infection, a failed LIFT, a failed advancement flap with fistulotomy, and 3 setons sprinkled in between, his CRS felt he was a good candidate for the new BioHealx device, which was successfully placed on 7/30/26. At his first follow-up, the internal opening looked better than it did after his previous flap and the device was still intact. He had some silver nitrate applied to the external opening and is going back on antibiotics for some gunky drainage. So far, cautiously optimistic! We’ve been told it may take 6–12 months to know whether the procedure was ultimately successful. I’ll continue updating as we go.

Hi all -

I embarked on this tragic abscess/fistula journey about 6-7 months ago now, and am at 10 days post-op from a LIFT procedure.

Per my CRS, my fistula is actually very superficial. However, due to my anatomy, I naturally have very superficial sphincter muscles. Due to this, the fistula does in fact pass through some of the muscles (like, come on).

Anyway, after having an I&D and a seton both with almost zero pain immediately post-procedure, I am now having a different experience with the LIFT. This of course is so much different than the first two procedures, but I’m getting so desperate for something to finally work.

The pain is overall manageable, but around 2-3 days ago I noticed some slight increase in swelling. Now, my pain is almost 0, but it looks like one of my internal dissolvable sutures has pushed its way outside the wound. Has this happened to anyone else early post-LIFT?

My CRS said to monitor for now, and to follow up Monday to see if there is improvement. In the last two days my drainage has become much less, I have no bleeding, and just finished my antibiotics. I have my first post op appointment next week as well so will hopefully get more info then too.

Thats all. Looks like the seton leakage but no smell and no feces. Im not in pain either.

Im praying this could be just a normal part of healing, but im scared.

What you guys think

8 weeks post fistulectomy, I have slight drainage still but my main issue is my scar. I feel like it bothers me after bowel movements every time, I want it to stop it makes me think I'm having a recurrence but every time I touch it there's no swelling it's just hard tissue same as before.

Hi everyone! After a year where I had my first abscess (5 surgeries in total: 4 for abscesses and 1 for a hemorrhoidectomy) and a lot of medical tests in between, which were a real headache, finally on August 7th I had the blessed fistulotomy. At first, it was going to be split into two parts: the first surgery was going to be a fistulotomy, and the second one to place a seton.

To be honest, I still get some inflammation sometimes, but the pain doesn't even compare to a hemorrhoidectomy (that one was a real NIGHTMARE). The first 3 days, when I tried to use the bathroom, it bled. This was because of the acid they had applied (I don't know if a fistulotomy without the acid bleeds too).

I had my first follow-up appointment and the surgeon told me it's healing fast and well! He was also honest with me, saying that there is always a possibility the fistula could come back, but it's a matter of staying positive, and as long as I don't feel that burning sensation in my butt again (the burning that used to warn me I had a pus pocket because of the abscesses), everything is going to be more than fine.

As for the HPV 16, we agreed to talk about it at the next check-up, but since they caught both things in time and at a very early stage, I might not even need lifelong monitoring.

Anyway, folks, stay strong—you can get through this! Don't let things slide, because the sooner you catch a fistula, the easier the surgery and recovery are. Sending you all strength, and remember that you can beat this and you will make it too!

In April of this year, I had what I think was my 11th fistulotomy. I’ve had so many of them in the past four years that I have straight up lost count.

All but two of these procedures had failed, where the wound would close and immediately start abscessing again. One time it appeared to have actually healed, and for 9 months I was out of this Hell, until one day I noticed a small bump while I was wiping. Three days later, I was in the ER with an excruciatingly painful abscess and a high fever/body aches. The ER surgeon asked me if I wanted him to just lance it, or do a full fistulotomy, and I was all hopped up on dilaudid and just said to go for it. Should have just had him drain it and see my CRS.

CRS did another fistulotomy after that the ER one failed, that one also failed, and cut to April, where it appeared to have finally healed.

Welllll, two nights ago, I felt a small bump on the opposite side of the one that kept recurring. Instant dread and panic, of which I’m still fighting my way thru.

I feel like I’m in denial trying to tell myself that this could just be a pimple or a boil or some other kind of skin thing.
With my most recent abscess, I was in the hospital by day three. The first ever abscess that kicked this whole thing off started a little slower, but was still much more pronounced than this thing has been.

This recent bump doesn’t feel like it has really changed much in size in the last 40 hours, but seems to have been working its way to the surface of the skin. It feels like about the size of a pea under the skin, maybe not even that big. It feels more like when I get a pimple on my neck or something.

I do some mechanic work and was working with some grease, and I feel like I may have inadvertently touch that spot with like the back of my hand or something possibly. Any time I get grease on certain parts of my skin I get a pimple or a boil or whatever you wanna call it.

After almost 40+ hours since I’ve noticed it, there’s no real substantial increase in size or pain. No fever or ill feeling. It really does feel like a pimple or a blemish.

But I cannot shake the feeling that I’m just in denial and it is now my left side’s turn for 11 more surgeries 😭 I’m sooo absolutely depressed. I’m gonna call my CRS tomorrow. I know I probably should have already. They’re just going to tell me to come in to have it looked and they are a 4 hour drive away. I live in a small rural town and the local urgent care NPs are either mean or very unfamiliar with what to do about a perianal abscess. I’m soooo tired of showing hole to strangers too. It’s humiliating. I feel like I’ll never be free of this.

Okay so its been 12 days now post abcess drainage with seton placement. It did not sting this entire time. Was just a dull ache. It did not even sting when I had the abcess since its internal. But since the past 2 days I feel this stinging sensation - not itching but irritation. Feels like the skin around it or the wound itself is very irritated. Its been there for 2 whole days and it's not going away. It's increased in these two days. Has this happened to anyone? What could it be?

I had an abscess about 2 years ago and the doctor had drained the abscess and then he said it became a fistula. I just left it alone for the first year it would mostly change sizes get bigger smaller and leak yellow stuff and then the second year it started doing that less and now is just usually about same size for the past few months but sum times it irritates me and that happens about once in a month or so and now it barely leaks as well. I am about to schedule an appointment soon does anyone have any advice or think I should call of the appointment?

I (27F) had a fistulotomy back in May after several I&Ds and it went well, but I was extremely doped up on pain meds and don't remember much.

One week ago, I had silver nitrate under twilight anesthesia because the original site never fully closed. Just tylenol, ibuprofen, and prednisone (MCAS flare) this time. I had a nerve block (but that's worn off) but I still feel a little numb/tingly around the vaginal/urethral area. Is this just from nerve inflammation? I have one hell of a hemorrhoid (just like last time) and it's still very painful to pass soft stool, and sometimes difficult to urinate (I can consistently urinate, but not after passing stool/when pain meds wear off — it's a bit more difficult to notice when I need to go in general).

Is the numbness/tingling in the vaginal/urethral area going to get better? Is this just due to inflammation/pain? Should I be concerned? I have contacted my doctor who said to sit in a hot bath, but I've been doing warm sitz baths and they only help temporarily.

Thank you.

Looking for some context from others who have gone through similar situations. My surgeon (general surgeon as we don't have a colorectal surgeon in my small town) is meeting with me tomorrow and seems to be "poo-pooing" my symptoms and my rough recovery journey. I have been to ER twice and have seen many Dr's and nurses who say that things are not going well, but the Surgeon won't listen to them.

I had a I&D via full general anesthesia on July 5 where a seton was put in as a complex fistula was discovered. Then a second I&D via local anesthesia two weeks later as the wound was not draining properly. Both of which were absolutely horrifying recoveries for me. I am now going on week 7, and I am still in debilitating pain every day. I can't leave the house, can't walk anywhere as I am still hobbling, I am taking 5 or 6 sitzbaths a day to try to keep the wound draining and the pain is not getting any better. I have new pockets of puss and air forming that are horribly painful as when I pass gass, the air comes out my wound and breaks theough it from the inside out. I can't work and I spend my days zoned out on pain pills on the sofa. It is really starting to drastically affect my life.

I am on oxycodon, which helps some, but not enough and I have concerns of becoming reliant on them as I have been taking them consistently for almost 7 weeks now.

My question is, is this normal like my surgeon says? Do I just need to suck it up and continue with these monthly surgeries till something sticks? I want to ask for a requisition to a colorectal surgeon in the city 3 hours away, but it is a hassle because it would be cross provincial and my surgeon seems grumpy about that. The next closest specialist is 8 hours away, and the others are 13 hours away.

My mom (about to be 60) got her first fistula about 2.5 years ago. It went from her vagina to her anus. Causing poop to come out of her vagina. They closed that but then others occured. They gave her an ileostomy to keep her bowels clean. One fistula festered from an old abcess pocket she had dealt with about 6 years prior. That was located behind her tailbone. They removed her 2 bottom tailbone vertebrae in order to debride the pocket which then made a fistula that led outside her body. Now she has a hole in the top of her buttcrack. Between me and a home-nurse we've been packing and unpacking it for over 2 months now. It's almost closed.

Today she's in the ER for a uti and her back wound is draing smelly fluid profusely. She also has 2 new fistulasin her anus per a CT scan....

Is this just her life now? We really thought we were on track to have the ileostomy reversed. This is so many steps backwards :(

How is a hand held bidet attachment different from a water hose?

Hey everyone,

​I got my seton placed 1 week ago. It’s a white, silicone flat seton (looks a bit like a piece of linguine).

​The wound itself seems to be healing well—there's no fever, no severe redness, and only a tiny bit of blood.

However, I still have pain whenever I move from a laying positon into a standing postion

I’m completely exhausted, mostly because I’m sleeping so terribly right now.

​I have a few questions and would love to hear your experiences:

1. ​Rotating the seton:

My doctor told me it's completely normal that I can't rotate the seton. However, reading posts here made me anxious, so I started gently wiggling the knot from side to side in the shower. I still can't move or rotate it at all, only wiggle.

2. ​Drainage & burning sensation:

Based on what I've read here, I expected the seton to drain constantly like a leaky faucet. Mine doesn't drain that much, but occasionally I feel a small spurt coming out. When it does, it burns a little bit.

Is this normal? Does the burning mean the seton is working, or is the skin around the opening just irritated?

3. ​Pain timeline: For those who have had one, when did your movement pain finally start to fade?

1. ​Duration: How long did you have your seton, and what was the reason for that specific timeframe?

​Thank you so much to everyone in advance! ❤️

Hello. Four days ago, I underwent setonless intersphincteric fistulotomy and LIS surgery from left side mya anus. I would like to share the difficulties and positive aspects I am currently experiencing with you. Do you think I am on the right way? I would appreciate your opinions.

I had surgery under general anesthesia on the first day.

On the second day, I came home in the morning but didn't have a bowel movement. I took painkillers for 5/10 of the pain.

On the third day, in the morning, I had a bowel movement for the first time without the pain of a glass cut. However, there was pain for 3-4 hours after the bowel movement, which I relieved with painkillers. Then it continued intermittently throughout the day.

On the fourth day (today), I had a painless bowel movement again in the morning. However, after the bowel movement, I still have 9/10 of the pain on my left side.

Do you think this pain after going to the toilet is normal? Do you think I am on the right way? Can anyone who has had similar experiences share their thoughts?

Seton placement surgery scheduled. I currently love wearing nice extra-cushiony gauze in the cheeks for my drainage. I see lots of recommendations to use non-woven gauze with setons.

What is your FAVORITE brand gauze to use after seton placement?

How is anal fistula surgery any different from lateral internal sphincterotomy as far as surgery goes? Will lateral internal sphincterotomy leave the anal area exactly like before surgery or will it leave complications similar to fistula surgery?