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Has anyone had personal experience with rectovaginal fistula repair?
After surgery in August for hemorrhoids and rectal prolapse I was left with fecal incontinence. Soon after going home from the hospital I noticed fecal matter coming also from my vagina. My surgeon said that may have occurred when an attempt was made to remove a fecal impaction that was found during the surgery. He then recommended doing a temporary colostomy. This was intended to allow the rectum and colon to heal for a future repair of the fistula. This was done in September. The morning after the colostomy surgery, my surgeon announced that the 'bridge' ( small plastic piece intended to support the loops of bowel ) was missing. He did not know when or where it had gone. I spent several days in the hospital but eventually went home and had Homecare visits to instruct and help us with the emptying and cleaning of the ostomy appliance. With no support for the bowel loops, my stoma was recessed and has become extremely recessed in the next months. This makes for more difficult care and now the opening that is meant to empty into the pouch, has recessed to the point where it has sunk to to the bottom of the area, barely visible. This may be the reason that i have as much output of stool rectally as into the pouch. After a couple of ER visits, one for ostomy pouch leaking bloody stool, and one for urinary retention, and later, a blood clot, I had lost confidence in my surgeon. My family all was urging me to seek a specialist. I did find a surgeon and now am scheduled for a Rectal Exam under Anesthesia with possible rectal flap procedure or possible SETON placement. He told me that in my situation I have probably less than a 50-50 chance of regaining normal bowel function. He also was less than encouraging about fistula repair outcomes. I am looking at this with more and more trepidation and can't find much online that leads me to believe this will be a positive experience. My primary care physician also made the remark "I hope he told you this is a difficult problem to fix." Do I have a choice? I feel now that everything is broken beyond repair. As of now, I'm spending most of my mornings in the bathroom, first emptying my pouch, sitting on the toilet trying to allow stool to exit my rectum but afraid to strain to help it.....and having the constant feeling of needing to have a bowel movement, As soon as I get cleaned up and stand up from the toilet, I have the urge again to sit back down. My new surgeon suggested tap water enemas for a week to clear out the colon. I did this and the first day I did get results but after that, the water squirted right back out as though it was hitting a wall. Then it seemed as though it might be exiting through the fistula. I stopped the enemas because I was afraid I was going to make the fistula worse. I'm counting the days until my procedure just after the first of the year. I have doubts that I will ever be in a condition which will allow reversal of the colostomy. At this point, I could deal with the ostomy if I did not also have to coax out the stool in my rectum. Has anyone out there had a successful fistula repair?
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@blinken I'm glad that worked for you! I had my j-pouch removed and a permanent ileostomy in 2002, so at that point my fistula went away 🙂
Prior to that it would kind of come and go... But I had so many other issues with abscesses, inflammation and fissures that the surgery made sense for me.
@susanf8
Hello, I am doing ok. The fistula was never repaired but finally closed or at least has not been an issue in the past few years. I need to be religious in following dietary recommendations in order to keep stool soft. I must not strain because it increases the possibility of re-openeing the fistula thereby necessitating another, permanent colostomy. Eating raisin bran and apple chunks everyday isn't a huge price to pay for the normal bowel movements! I also seldom leave the house before 10a.m. if I can help it. Sometimes it takes a bit longer to complete my bathroom chores. Again-small price to pay. I hope things work out for you!
@susanf8 thank you!
@lhstephenson FYI to notify a member, put @ in front of their name. If you do a reply to a comment, it adds it automatically. But it doesn't do it if you comment on the first post of the thread.
@blinken
"Commenting to blinken, who originally posted this question regarding fistula repair in 2020, how are you doing now?"
@mahoney , wow! And I just thought I had problems! Who repaired your fistula? I had 2 surgeries last year, and neither was successful. I’m tired of being chained to the toilet and going thru a box of pads a day due to this dual vaginal/anal nastiness. At this point, I would gladly travel across country if I knew someone existed who could repair this fistula. Thank you for your response.
Commenting to blinken, who originally posted this question regarding fistula repair in 2020, how are you doing now?
Thanks for letting me know. I was hoping there were better products these days. Mine was 30 years ago. I do know I have a neighbor that decided on the ileostomy and he seems very happy and gained all his weight back and said he has no problem with a “belt” which he had never heard of so I had a feeling things that improved. Thanks for your feedback.
@frh The products have improved. Everyone has clipless bags, and some kind of covering on the bag to help with the crinkling sound.
I had way worse sounds with the j-pouch than with my ileostomy tbh. When people comment on my gut sounds (which has been very rare), I just say I have a really loud stomach. Because that's pretty rude.
@susanf8 thank you I just remember that long bag and the skin issues and then worrying about the sounds. It made when food would be coming in it and the smell of certain foods. It just sounds exhausting only in a different way as all. But thanks and it just might have to happen for me as well, but I think I might be trading one thing for another. As is in life.
@lhstephenson oh dear, that was not enough water. I’ve been doing this years and I do a teaspoon with at least 12 ounces of water, especially if you’re doing it with some of the Chia ground up otherwise it will stick in your throat and you could choke. So here’s what I do. 1 teaspoon of the psyllium fiber a quarter spoon of the Chia to start with (you can go from there to see how much more cheese you can add later if if it starts working better.) but stir like crazy in a 16 ounce cup of water at least 12. Wait a minute and then follow it with about a cup of water so that it goes down your throat just to ensure. If you notice a little improvement with the small amount of Chia, increase it until you know what works for you. But the sprinkle of Chia both in my pancake batter, etc etc will really help slow things down and absorb liquids and bulk the stool better. No, it’s not TMI. I agree this is a good group because I never usually tell anybody what I go through and it’s just interesting to know other people are going through the same things. Find a good balance, but it will help. I’m hoping you can report success. You get a huge bag for around $10 and it will last through the year of the chia. I don’t tolerate it as well if it isn’t ground, but you might try it without in pudding and such. It’s handy to have on hand when you’re out and about and it’s not a weird consistency and it has a mild nutty flavor.