Turnbull-Cutait (T-C) procedure: Share your experiences

Hi, thanks for asking how I am, how are you? I’m 10 weeks post surgery and find every day is different and face different challenges. I’m considering getting a stoma bag in the future as my future with LARS seem a life of irritation and unpredictable bowel movement. I start my Biofeedback theory next week. Will see how that goes

@jonnypouchw In the UK we are not allowed to be on Oxicodone for any length of time due to it being highly addictive. I found Oxicodone helped me loads but they have stopped prescribing it to me

I have a question for those who have gone through a resection after having a Colostomy a year before. Is it worth it and do you have any problems after it is done? Is it as complicated as having it done for the first time ? Do your bowels go back to normal?? Do you heal faster than the first time?? Do they fix any hernias while they're in there?? Could someone please help me who have been there.....Kas

@verol65 I just found this Mayo site today. I had a colectomy with oleo anal pull through and J pouch back in 1983. The worst part of the whole thing was the temporary ostomy which left me very raw around the stoma. Here I am 43 years later and have developed a horrid rectal vaginal fistula. I believe I’ve had the fistula for five or six years, with only gas passing in the past. Last year, I noticed fecal matter coming through, and of course, not having a colon it was liquid fecal matter. I found a surgeon in Dallas, Texas, who trained with my physician who has since passed away. He did a Seton insertion in November, and when that didn’t work, he tried to repair the fistula in early December. Nothing seems to have worked. I am having uncontrolled dumping into my vagina, which is quite disgusting. I’m very curious about this turn bull procedure you speak of. The only option he offered me was a temporary ostomy to see if the fistula would heal. I’m doubting it will heal being that it has been there for so long. I mentioned a pouch revision, but he said that would be a very long extensive surgery and I would still have a temporary ostomy. I am very curious as to the procedure you had, and if you find it has been effective. Thank you for your help.

@lhstephenson I'm sorry to hear that your are not getting a convincing proposition for a solution to your recto-vaginal fistula.

Here is a bit more of my story. In Dec. 2022, I had a transanal resection of a big polyp. The biopsy revealed positive margins, hence a diagnostic of rectal cancer stage 0. Since the surgeon considered that she would not be able to do a new and effective resection given that it was a matter of margins, I had radiotherapy with oral chemo in Feb.-March 2023. By June of the same year, I started noting something and by August, my oncologist confirmed that I had a recto-vaginal fistula, due to the resection being quickly followed by a full radiotherapy protocol.

I spent the next three months looking for a solution I could feel confident about. My original surgeon said that a vaginal repair was not necessary, according to a gynecologist friend of hers, and that she could do a flap to close the fistula on the rectal side, with a temporary colostomy. However, the possibility of a new fistula forming was very high, over 60%, if my memory is correct. That was not a happy solution for me. I started investigating and I consulted two more surgeons. Both wanted to first see a new colonoscopy, which not only showed the fistula, but a new polyp. Both agreed that I should go for a radical surgery: the two-step Turnbull-Cutait pull through, which would garantee that my risk of a new fistula would be that of a normal person and also it would reduce my risk of the cancer returning. And a vaginal repair

So in Jan. 2024, the first surgery was to remove my rectum, sigmoid and mesorectum, and to pull a bit of my colon through the anus. After a week, that little bit was cut and I had a coloanal anastomosis. This allows one to avoid a temporary colostomy and avoid a J pouch. My surgeon was clear that this meant that I would suffer from LARS. He had trained for the surgery in Texas, not sure where.

Two years after the procedure, I'm happy with the results. It took a while for me to adapt to my new fisiology. My vagina shrunk a bit, was dry and the stitches started incommodating me, but all got resolved in due time. Now I can have sex as I did before, even if sometimes I need to interrrupt to go to the bathroom, because sometimes it makes things move in the colon, and sometimes I can't stand the pressure of some carresses or due to the position, on my colon or anus. But I have a very satisfactory sex life again.

As for LARS, it's been an adventure in learning to manage it, but in my case, it's mostly light.

In short, I believe the procedure was effective. I went for my second-year controls post the Turnbull-Cutait and everything is in order.