Seton: Draining or Cutting? | Anal fistula surgery

[@yourfriendlyproctologist]

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[@olawalehandel]

I’m on my 3rd day of recovery from my haemorrhoidectomy surgery but the gauze placed in my rectum won’t come off, I’ve had several sitz baths and it’s not working 😭 please help me

[@ishanimaheshika4400]

Hy doctor.I ‘m Crohn’s disease patient.Already I have done a seton surgery for anal fistula around 1 year and 2 month. So again blead my (previous setons) fistula.Can you tell me why is that happening?

[@marthanagle8903]

Can this product be use while I have a seton ?😊

[@mphophandavhudzi2815]

Question is how do treat the smell? I've done the surgery as well and the leaking is pretty much better than before but I just can't get rid of that smell at all I completely smell shiit no matter how I bath even if it's 3 times a day, even sit-in bath don't work. So how do you treat the smell so you can have better hygiene and cope around people??

[@tracy3812]

You are so compassionate & funny! Your parents raised an amazing person. On another note, I will never think of Seton Hall (college here on the east coast) quite the same way again.

[@JdDabbene]

Ha, I have a family member that works there. I live like an hour from there

[@Rogerramjet4321]

Thanks for explaining this so simply. All your advice has made a world of difference to me. Pain free since January 🙌🏻

[@yourfriendlyproctologist]

Congratulations!

[@Joses213]

You are so unique Dr. Chung. Thank you so much for the best information as always!

[@yourfriendlyproctologist]

Thanks for the feedback. I hope it helps!

[@jordanhollyx]

I had an abscess surgery in December 2023, today I finally got an appointment for my seton insertion procedure on September 30th! Not sure if i should have been made to wait this long but a transphicteral fistula that’s constantly draining and in pain 24/7 has affected my life horribly! Praying for the day I don’t have to have a dressing between my cheeks!!

[@Lanos666]

You’re not alone

[@hichamhachoum9607]

Do the surgery and everything needed, and take pain killers to get rid of the pain and the fistula definitely, please be brave

[@11_pawz]

I’m going in for my first surgery for this on Friday. It’s a result from a trauma injury leading to an abscess a year ago. I’m very scared about the pain since my first surgeries for the abscess were extremely painful. Thank you!

[@GamingBoy-ld5kk]

How was it? Painful? How long did it take to dry. Like to completely form? I had it this Thursday today it's Tuesday. It's a bit painful. He comes daily and cleans and puts some ointment and some other stuff. But I just want to know how long will it take to dry?

[@Sablesuit]

Thanks for the video. The surgeon my wife had was very smart and capable but couldn't explain a cutting seton in a way that made sense. This video helped relieve a lot of anxiety.

[@renerenatorivera9062]

I had ana anal fistuotiomy in Jan. 2024.Seton seemsplastic. Have had 3 tightening sessions(PAINFUL), another scheduled tomorrow...Cant wait to finally get this thing out!

[@eggrat3381]

hey did it heal??

[@nunasdreamnz]

Thanks. Having a drain inserted tomorrow so now it's far less intimidating!

[@georgestein7484]

What is the pain level while tightening. Had fistulotomy last week. Not superficial. Seton in place as a drain and cutting. Do they numb you up for the tightening? I really am worried about having the tightening done (the pain of the procedure. Thanks for great videos!

[@StomaatHome-a]

I have a non standard reason for a fistula. I had a pyogenic granuloma removed that was growing from my bowel. There was a hole in my bowel so the cavity that was left after tumor removal ended up with a fistula forming right through it from bowel contents. No follow up... Many trips to hospital in the following 5 months with pain, fluid and stool passing I finally got diagnosed with a fistula. Then over the following 6 years I had 9 operations to try and modify the fistula only to suffer bowel incontinence on the last surgery so now I have a colostomy AND still have the fistula to manage with the mucus 🙄 tbf at least I can go out of the house now without thinking I'm going to have to wear a nappy... I've started a KZbin channel to try and bring some comfort and tips to people. Mainly spoken about the colostomy so far but fistulas are next! UPDATE: After a recent mri they have now found a second fistula connecting to a very unfortunate place 🙄 🤦🏻‍♀️

[@jefftaylor844]

Watching all these videos, I can't help but think that here we are in the year 2024, and all the current treatments used are from the 19th and 20th centuries. The advancements in this field are pretty well zero. You'd think that which all the technological advancements in our lives, this field (curing fistulas, etc) would be much further along.

[@annakoshel9536]

Riiiight! And an interesting fact is that a seton was first used and described by Hippocrates two millennia ago but still remains one of the most effective methods

[@jefftaylor844]

@@annakoshel9536 ... and NOT a cure.

[@StomaatHome-a]

Because these conditions are so difficult to treat! Tbh after 9 operations and now a colostomy I'd have rather had them do the colostomy FIRST and just cut the fistula completely out! It's been a 7 year nightmare and I say this as a mother that's given birth naturally to 3 kids and one of them was a 10lb homebirth....

[@crystalk98]

​@StomaatHome-a oh God you poor thing? Do you have Crohns? I haven't even started my fistula healing journey yet, but I'm dreading it. I'm hoping I'm one of those lucky one and done people, just one procedure to get rid of it but reading stories like yours makes me think I should just live with my fistula

[@jefftaylor844]

@@crystalk98 ... I have put off surgery for almost two years now. Zero plans to have it anytime soon because mine has somewhat healed on its own. The devastating risks make me take a wait and see approach

[@TJ_Rider]

thank you for this video Dr Chung!

[@yourfriendlyproctologist]

Welcome! I hope it helps.

[@TJ_Rider]

It does, i have been living with a draining seton since September. Though today I discovered a mild haemorrhoid near my seton. I am hoping i can use proctosedyl to manage it.

[@itssania1]

my second surgery on 8 December 2023 now I fully recovered the cutting seton

[@rozinashahzad3323]

Hello how are you please shear your experience I'm suffering complected fistula 😢 I'm so worry

[@Maddy_568]

After cutting seton,how many days it take to recover the wounds? Plz tell😢

[@mphophandavhudzi2815]

Question is how do treat the smell? I've done the surgery as well and the leaking is pretty much better than before but I just can't get rid of that smell at all I completely smell shiit no matter how I bath even if it's 3 times a day, even sit-in bath don't work. So how do you treat the smell so you can have better hygiene and cope around people??

[@russwhite3952]

i developed 3 fistulas within 40 days 2 or 3 weeks apart and my proctologist said she couldnt help me after 2 , now im in limbo waiting for another proct... she recomended, i hope the waiting on the appointments dont kill me

[@GamingBoy-ld5kk]

How's it now? Operation done?

[@adithyaamin396]

Sir, for how long we should take stool softener after fissure surgery? And how much we should take? I am taking Cremaffin plus 2.5 ml and i had fissure suegery in August. Please reply sir.

[@sagartripti]

@adithyaamin396 how are you now? Did you have fissurectomy surgery?

[@kathleenrey8841]

I had my second and final surgery to deal with a fistula. The first time involved a draining seton, and this time a cutting seton. I had surgery two days ago and can say the cutting seton is way more uncomfortable. My doctor didn’t say how long it would take to fall off, and did seem to think a tightening would be needed. Is the post-surgery discomfort and recovery that much harder with a cutting seton?

[@marksteps1712]

Hey Dr C, found you a few months back, so pleased to find someone talking about these delicate and embarrassing matters, talking sense and letting me educate myself in private. QQ, Is the Rivivol available in the UK or can you recommend a UK alternative please. Many thanks, all the best, peace and love all and stay safe

[@MarianaGabriel-i4r]

Thank you doctor for this video. I live in South Africa and I have been battling with anal fistula for years. I currently have a seton in for about a year and I was told not to sit in Epsom salts..just normal course salt. Is is safe to do sitz in other salts with anal fistula?

[@ares9748]

my seton dropped down after a month of surgery and i have a question , is it normal? and for the second stage surgery would this make the surgery more difficult to find the fistula path??

[@Modernsoul2024]

I just had surgery 8 days ago and my crs said it was just a superficial with no sphincter, so I ended up with a fistulotomy but he also placed a drainage. 2nd day it fell out somehow and had it replaced at the ER. On day 5 I called my CRS, & told him that I was in alot of pain. So I went in and found out the pain is actually on the opposite side and the NP palpitated and felt a hard lump. So now Im being sent to an MRI to see whats going on. I really though this would be an easy recovery 😭.

[@dronem_w_przestworzach.]

And what was after Mri?

[@inwiththenew]

how are you today?

[@obijustinpaul4850]

Am booked for surgery for bleeding hemorrhoids by 19th Jan 2024

[@900KING2]

Today's the day i go for my surgery 1/27 I wish you good luck! Peace and calmness during the stressful surgery. 🙏 please lmk how it goes.

[@leramaricel5686]

Hey Doc,i was had a surgery for fistula 3months ago and y surgeon he told me to to mri again to remove.Do i need an mri before removing the seton?

[@mwdaniel]

Had superficial fistula and perianal abscess surgery last week. CRS installed Seton for drainage and said he may be able to remove it in a couple weeks at our follow-up. Question.....will a seton continue to drain puss as the body is attempting to heal that seton hole opening or should the drainage cease, indicating it is now free from puss and the seton can be removed. How is the determination made?

[@michaelaguon4607]

Thanks Doc

[@allanamaya07]

Does draining setons come out naturally?

[@rafiyay-dm1fo]

Hi doctor, i am from i am from india my dad suffer from anul fistula can be cure by only surgery or any other treatment there, help me by giving any suggestions doctors ?

[@GamingBoy-ld5kk]

How is he now? What did u opt? Operation or?

[@tysoncamaro9408]

Is that seaton was hurt😢

[@FromProfessor]

Is there any good alternative for superficial ano-rectal fistula ..other than this....????

[@nandinigoswami6241]

Hello dr. I have a question about 💩. What to do if you are going daily but the volume of stool is low? please respondd

[@deepakbansal4166]

Fistula piles coming

[@bobe.5949]

Is it normal to have some small discharge after visiting toilet in cutting Seton ?

[@R_c077]

Can you workout/ lift weights with seton?

[@R_c077]

Updating this because no one answered. Yes you can. I’ve been working out/ weight lifting and it all just depends on the placement of the seton. The first one I had it was a bit uncomfortable tbh. The second one placed is much more comfortable and I’ve had it for over a month almost two months and I’ve been lifting just fine.

[@Garlicfriedshrimp]

@@R_c077 is this a cutting seton?

[@jackdaniels4346]

Thanks 🙏🏻

[@termitesarenotgoodforhomes]

A hopeful question. Can a drainage seton cure a fistula ? Mine is high intersphincteric :(

[@artofwastemanagement4484]

5 months before I had perennial abscess surgery horseshoe shape. Long surgery without stitching. Woond is cure except one small hole. Pus is still comming. How many months it will take for fully cure.

[@TheJokerman26]

Had the same surgery but not horseshoe shape. That small hole with pus drainage is most probably a fistula. Get you examine and get an mri to confirm then decide the process with your surgeon. Best of luck

[@PureGrime616]

I just found out today that I have 2 fistulas and they have to do several surgeries. I just don’t even wanna do it.

[@gallager2116]

Yea me too. I just had 1st surgery that i didnt want done. Wasnt as bad as i thought but def not a enjoyable experience. I got 2 setons about week ago. Good luck and speedy recovery

[@tantebaguette]

There'd hope :)

[@alexanderkuznietsov932]

I dont understand how seton can pass through muscles fibers.. it will just cut them apart

[@zyralex820]

I have Crohn’s and had a fistula. Still recovering and have had my seton in place for 10 months now. I had quite a large abscess. I don’t know when it will heal or how much longer it will take. I do se my surgeon next week so we’ll see what he says. I do know the inflammation has significantly gone down. I’ve started Skyrizi the past 4 months and so far it’s working

[@sandeshnarayana1967]

Hi, I am also having same problem. 2 days back, I had surgery, and they found it is complex fistula and they placed seton. I am getting a lot of pain and iritation. How you are managing for 10 months. Is it not painable after some time? In 10 months, whether you did frequent visits to the hospital and did surgeon did some change on initial seton. Or you're having the same seton which was placed 10 months back

[@zyralex820]

@@sandeshnarayana1967 my pain worsened as mine was complex and I had a very large abscess with a very large pocket after it was lanced and drained. I ended up needing a second seton. While I was on many many courses of antibiotics I felt like they never worked, they do, I just had a large pocket to heal and fill. I did request to be seen under anesthesia as my pain worsened and pain meds didn’t help. My surgeon cleaned the inside of my abscess and packed it with gauze which I removed myself two days later. Bowel movement were excruciating because I had fissures on top of that. I was getting hopeless and depressed because of the pain. I pleaded with my pcp and GI specialist and they provided me with continued pain medication and lidocaine cream. It made things tolerable, or less miserable, but still averaged pain level 6 or higher. My pcp after the pain never ceased thought of prescribing me duloxetine (cymbalta), which is an anti-depression medication, however it’s also used for nerve pain, and I kid you not in 24hours after taking I was pain free, I was able to stop pain meds. Looking back what I would do sitz bath with epsom salt in a bathtub and NOT on those portable ones you put on a toilet seat. I used warm to hot water and lied in the water for 10-20mins. It took medication change to help ease my active Crohn’s as well. My entyvio stopped working after 5 years or so, so now I’ve been on skyrizi and it seems to be doing its job. Please ask more questions! It’s a very tough thing to go through. Ooohhh update… I have surgery scheduled in January to remove 1 of my two setons since the inflammation has decreased and there’s virtually no pus draining anymore.

[@sagartripti]

​@@sandeshnarayana1967how are you now?

[@Maddy_568]

Cutting seton was placed on my ano & seton was fall off itself.. So how many days it takes to cure the wound? Plz reply Dr.

[@DibakarRay-ft2ko]

I don't surjery homeopathy medicine can remove fistula

[@danenglish6148]

I had a cutting seton placed this week. I don’t have Crohn’s or diabetes, and this is my first seton placement. I am worried because I am scheduled to meet for bariatric surgery 2/14 to get access started. Would I be eliminated from bariatric surgery because of having an anal seton in place?

[@Lanos666]

How did it go ? I had mine today

[@Lanos666]

How long does it take to heal? Any pain over time ?

[@Maddy_568]

My seton was dropped down itself..no pain .. But pus still coming from the where seton was placed.. I don't know how many days it takes to cure the wound 😢

[@mewtwoking2883]

Hi doctor I just had my rectal advancement flap and removal of seton 4 days after I’m having some sort of brown liquid leak from my anal area pretty constantly I’m not sure if it’s blood mixed with something else but is that normal ? I think one of my stitches may have come out

[@aminmohammad8564]

Can anal fissure last 2 months? In the beginning the pain was too much during bowel movement and after. The pain has not disappeared fully. The pain is still lingering a bit. What should I do? Btw I am from Afghanistan.

[@GinaSherman-gc2cx]

Take a lot baths . Mine last two months very painful. Eat kiwi it helps .

[@yourfriendlyproctologist]

Anal fissures can last a long time.

[@aminmohammad8564]

@@yourfriendlyproctologist thanks for the reply dear doctor. At day time I don't feel it that much. Sometimes at night when I wake up for no reason. It hurts a bit.

[@thepersonofporbandar7553]

I'm from porbandar gujarat, i have fisluta it was drain 2time gape of four month. i dont want to do surgery. I meet 2-3 surgeon in our area all are told me that rubber treatment ane other(without surgery) treatment are not working on fisluta. I want simple treatment without more pain, plz anyone suggest me. 🙏🙏🙏🙏🙏🙏

[@csamples6784]

I had anal fistula surgery 3 months ago. It was a superficial fistula.

[@sagartripti]

How are you now?

[@csamples6784]

@sagartripti it took a full 3 months to completely heal, but so far, I have had no further issues.

[@artxhit3sh]

Does homeopathy works for anal fissures?

[@sagartripti]

@artxhit3sh let me know if you opted for homeopathy as I'm suffering from chronic fissure and I feel I'll never be able to heal😢

[@Dang_Lin-Wang]

I managed to heal my anal fissure. Ate a fairly high fibre diet, lots of water, lots of animal fat to keep things well greased. Technique for pooing was using lube on little finger to open and relax rectum and using circular in/out motion until stool is felt. I would then cross my arms across my diaphragm and breath into my arms, leaning forwards. This creates a bit of pressure from further up to evacuate stool but allows you to totally relax the rectum using your arms as the pivot point. If you tense/spasm it's no good, needs to be totally relaxed. A bit of practice and it became easy. If you do get a slightly drier stool due to not enough fluids you can massage it externally from the side position to help get it past the sphincter without tearing.. hope this helps

[@sagartripti]

@@Dang_Lin-Wang due to the pain in the BH, it's difficult to insert any finger and the spinchter muscles are very tight resulting in retear 😭

[@Dang_Lin-Wang]

@@sagartripti I used durex alo vera lube and took it really gently, obviously I was lucky, sounds horrendous, sorry to hear that..

[@javery1313]

Good evening Doctor, I have a draining seton and my CRS just tightened it for the first time today. I forgot to ask him at the appointment but is it okay if I go swimming in the Gulf of Mexico off the coast of Florida for Memorial Day weekend ?

[@StomaatHome-a]

I live by the sea and found the salt water very soothing. Just make sure not to sit in wet swimwear for hours...

[@bonegrubber]

I've two now. One red and now my newest one is blue.

[@magamedaliyev8133]

And how many month they told you they gonna keep them there .? Last week they did for me fistula surgery and they putt blue one and she told me i need keep 2-3 month

[@bonegrubber]

@@magamedaliyev8133 Mine are permanent. Perianal disease or fistulizing crohns disease has no known cure, only management. I get to take these to the grave. Everyone is different I've heard and one case can't be compared to another. Best of luck with yours. I know that first month with my first one was hell on earth. The panic attacks... the anxiety. My doctor couldn't understand why I was struggling so much but I was. This disease definitely sucks eggs big time

[@momentousmanav]

I am indian this is Ayurvedic Surgery, its been 6 months it has not reoccured but the big scar bothers me it is better to go with it if this surgery heals this forever and don not reoccur.

[@nussahoeri1444]

Does anyone have any experience trying to have anl sex while seton is put on you? I feel useless to my partner. Is that safe to have sex while we have seton?

[@Jojo-vg3ke]

Hahaha 😂😂😂😂