Perianal Fistula

[jollyjoanne]

I know, less than pleasant topic.

I have had surgery on a perianal abscess followed by 3 lots of surgery on the related perianal fistula (not pregnancy related). And am now pregnant with my first baby, worried about all the potential side effects of carrying the baby to anything near full term and about the potential need for a c-section.

Anyone else been in a similar situation?

Have you read this thread?

Not the same I realise, but some of the people concerned may have had later children.

What are your concerns specifically about you going to term or the manner in which you deliver?

There really shouldn't be a problem, and having an anal fistula repair would not make you any more of less likely to have a tear during childbirth.

However, I can appreciate that you may be frightened of tearing and needed further surgery.

Are you still under the care of the surgeon that did your op or have you discussed this with an obstetrician?

Meeting my consultant on 30th, I have 4 different consultants for the previous ops and they were at a different hospital from the one I am expecting to give birth at.

All these consultants have stressed the importance of not getting pregnant before the fistula has healed. However, given it is has re-opened on 3 occassions over the last 6 years I have sort of gotten used to the idea that it may not really ever be properly sorted.

My midwife was concerned about the stress of both carrying the baby to full term and to the idea of having a natural birth. So I am trying to find out if anyone else has had any similar experiences. This way I will know if a natural birth is possible or not, or whether it is something I should be asking about, otherwise I am sensing they are going to encourage me to have a c-section. But I don't want to press to hard the other way if the risks seem to large.

I assumed that the fistula had fully healed, but it seems not- you poor thing.

I hope you get some good advice and answers to your questions when you meet your consultant.

Thanks. I am really hopeful that the consultant will put my mind at ease. It's just one of those areas no-one really wants to talk about including my DH who goes very squeamish everytime I mention it.

Hi Jollyjoanne,
Just popping over from the other fistula thread, which I know has a different focus, but thought I'd throw my tuppence worth in.
From what I understand, fistulae rarely heal on their own. They may close over, but then open again. It's why, for example in my case, there was no attempt to repair the fistula. It was excised instead. I think the science is that the tissue is, by virtue of hosting a fistula, not able to sort itself out most of the time.
However the main reason I popped in was because there's a school of thought that certain damage of this kind is down to a tissue type. Which may mean that even if the existing fistula had been sorted pre-pregnancy, you may be prone to damage that occurs in childbirth. Also, depending on the surgery, consultants may not want you to push. Again in my case, my surgery was on my anus/perineum, yet the 'tightening' they had to do makes me higher risk... whereas if they hadn't done the repair surgery I would have been allowed to do 'natural' again.
Anyway I am rambling but saw this (while working hard in the office, you know!) and wanted to quickly reply.
Please feel free to visit the other thread if you feel it appropriate.
All the very best to you and I hope you get the care/advice you need/deserve.

hi
i have a perianal fistula which occurred after an abcess in 2001. after about 3 ops on it I became pregnant in 2005. bizarrely the only time i had no trouble at all with it was during my pregnancy, previously it had been opening every 2 months or so, but it was fine throughout the entire pregnancy and i was even able to have a completely natural home birth, resulting in my healthy, beautiful daughter. however, within 2 weeks of giving birth i was admitted into hospital with another abcess on the same site. it was as if my body had stored 9 months of pus etc and it all then had to come out! since then it has been much worse, unfortunately this year i have had 3 further ops on it and numerous infections including mrsa. my health has been so poor that i have been unable to conceive a sibling for my little girl despite 16 months of trying. i am now awaiting another op to fit a plug in the fistula; if this fails, my consultant beleives i will have to have it completely removed and will therefore lose continence of my bowels. it has not been a good year!! i do hope this is of some help - it has been a nightmare but i am still so lucky to have a happy healthy child. good luck on your journey.

Hi all. As Cyee knows, I ended up with a rectovaginal fistula after my son's birth (long-drawn out, OP presentation, forcepts). Now it may be total coincidence but many years ago I had a perianal fistula which had to be excised. I think that there may well be something in the "tissue type" school of thought - some of us just have slightly more "fragile" tissues than others. Not that I, or any of the other fistula sufferers on here, are generally "fragile" in any other way!
OP, If I were you, I would press to see not just an obstetrician but a colorectal specialist too if you possibly can. Good luck to you and I hope you get the care you deserve.

Hello. I am new to this board, but not this topic, so I thought I'd throw in my 2 cents. I have had a perianal fistula since after my first birth (hospital, episiotomy, poor repair...) in 2005. The repair performed after the birth did not work. I did not go in for another repair (or even a check up, b/c I didn't really know what I had). Then I got pregnant with my second child. I had a water birth at home with a midwife. It was great. I tore through the fistula, which I was prepared for. I went to the hospital, got a repair from the "drop doc" as they called him, and signed myself out to go home. The fistula reopened about 3 days later. This past June I attempted another repair with a different OB. I was not informed that the repair surgery (done under local anesthetic in his office) might not work. Which it didn't. Since then, I have gone through a colonoscopy (to check for Crohns, which came back neg.) and been to a GI specialist who said that I needed to see a colo-rectal surgeon. But there isn't one in my town, so I put it off. Now I am pregnant again. The fistula has yet to be repaired. I dont know how I am going to handle this. I have not been to a doctor or my old midwife yet, so I guess time will tell.
Hope this helps others to know they are not alone.

Hi there,

Is there anyone out there that has suffered a 4th degree tear resulting then in a recto vaginal fistula?

There's a big support thread here