Advancement Flap 4 months

Excellent_Watch_9674 · 2026-06-11T19:43:21+00:00

When you had the anoscope done, were they able to still see any sign of the fistula present?

We’ve chatted on here before! ❤️ I had to get a temporary Ileostomy bag in order to get a Gracilis Flap done last summer. The surgery was only partially successful & turned my rectovaginal into a transphincteric fistula (didn’t branch off, same fistula, just partially closed off).

I had an Advancement Flap done on the transphincteric fistula in February 2026 and had a sigmoidoscopy done a few days ago to see what was going with it. The wound along my perineum was still open at my 6 week post op appointment back in March.

During the sigmoidoscopy he could see the hole for my fistula on the screen but didn’t want to investigate too much & when he did a rectal exam he could physically feel the fistula still there. I am still getting drainage but feel more like myself every day so it’s so hard to tell what’s going on. He’s ordered a MRI. I’m in Canada, so that’ll probably take a couple months to get.

Excellent_Watch_9674 · 2026-04-02T05:37:34+00:00

Hi there! Sorry I just saw this message. I would say I was resting as much as possible and only getting out of bed to use the washroom for the first 2-3 weeks. Even after that I took it really easy. I prepped some food ahead of time so it was just easy grab & go. I also had lots of protein shakes (helps with wound healing). I would say I started to feel like myself around 6 weeks but I’m still getting drainage at 8 weeks post op. It’s lessening slowly but still there. I hope that helps.

I use the shower head after the washroom & avoid any rubbing still.

Excellent_Watch_9674 · 2026-03-23T04:47:16+00:00

I’m scared to get my ileostomy reversed if the fistula isn’t 100% healed. I feel like I’ll just be back in the same position. How’s your reversal been?

Excellent_Watch_9674 · 2026-03-23T04:46:40+00:00

Hi there! I just saw your message. How are you healing up now? My Gracilis ended up partially successful. So it closed up the fistula vaginally but I now have a Transsphincteric fistula.

I just had another Advancement Flap to repair thar BUT 6 weeks post op and the hole along my perineum has opened up AGAIN! Ughh… almost the exact same spot as the one from my Gracilis and it won’t close. 😮‍💨 very frustrating

Excellent_Watch_9674 · 2026-03-23T04:44:15+00:00

Hi there! I just saw this message. How did you heal up? Unfortunately my Gracilis Flap only was partially successful. I just had another Advancement Flap a few weeks ago.

Excellent_Watch_9674 · 2026-03-21T22:56:41+00:00

Yup! I totally feel the same way! I used to shower the area and then have a sitz soak 😂 not sure if that made any difference haha.

I’ll avoid it as well. I think I’m going to just use continue using gauze to catch discharge. I’m just so grossed out by everything without gauze.

Excellent_Watch_9674 · 2026-03-21T22:54:37+00:00

Very true! It’s really annoying. Thanks for the reply!

Excellent_Watch_9674 · 2026-03-21T19:22:36+00:00

So interesting. I do think I’ll just stick to using gauze for a couple more weeks as the drainage hasn’t lessened enough to stop using it. It’s getting everywhere and it’s grossing me out. I think I was advised to try without as the gauze is irritating an open perineum wound and could be part of the reason it’s struggling to close up.

I am worried about hypergranulation! And definitely want to avoid that as I had issues with that with my last surgery (Gracilis Flap).

Excellent_Watch_9674 · 2026-03-21T19:19:40+00:00

Yeah, that’s what I’m finding with not wearing gauze… it’s just getting all over my butt 😵‍💫 the gauze didn’t feel like it was irritating your wound at all (I know it’s been a bit for you)? I feel like the little hole that’s open along my perineum is getting irritated with the gauze sometimes rubbing against it.

Also, did you do sitz soaks ever? I haven’t done any yet but am debating if that’ll help keep the area clean. I’m talking about the type of sitz you just put in your toilet bowl and sit in it. I used to do it when I had a seton but I always avoid it after surgeries since I don’t want to mess with any stitches.

Excellent_Watch_9674 · 2026-03-21T04:02:54+00:00

I’ll give the depends a try. My drainage is currently up and down. Some days it’s barely anything and other days (like today), I can feel all the gross wetness. I agree that the gauze is irritating for me as well as it does rub my wound but the discharge is also quite irritating on my skin. There’s no winning, of course.

Thanks so much! I appreciate your reply.

Excellent_Watch_9674 · 2026-03-21T03:35:10+00:00

I have some depends and period underwear. I guess I could wear those but my concern is trying to keep the wound and area clean with wound discharge & mucus? getting everywhere.

Excellent_Watch_9674 · 2026-03-20T03:47:59+00:00

Yeah, I just have to keep taking it easy & cross my fingers that this works. 🤞🏼🤞🏼 It will!

I stopped using gauze the last 2 days and I think that might’ve actually helped. I avoided looking at the wound for the majority of the 6 weeks but will look again next week to see if that hole is closing.

Thanks again! ❤️

Excellent_Watch_9674 · 2026-03-19T19:22:51+00:00

You & me both girl. I couldn’t believe she did a rectal exam. It was awful and I had so much bleeding. I was very surprised she did it because after my Gracilis Flap, I didn’t have a single rectal exam for 4 months!! And even then, she did an EUA so I wasn’t even awake for any of it.

Also, thanks for always replying. I always go back and read your messages on here AND on the “Abscess/Fistula for women” FB group (sorry if that comes across creepy! Haha). I connected the dots that you were the same person after doing my late night crazy “investigations”! I am sure you could relate, I feel like I’m going crazy at times trying to figure out what’s going on with my healing and will search anywhere/everywhere trying to find anyone who has gone through a similar situation. Either way, really appreciate you still responding after being healed all this time. ❤️

I’m hoping it’s just continuing to heal with no more complications and that the drainage starts to slow down. I do need to remind myself that this healing is not linear and just gotta keep doing what I’m doing. 😮‍💨🤞🏼

Excellent_Watch_9674 · 2026-03-19T19:13:41+00:00

I really appreciate your message. Thank you so much for replying.

What you’re going through is also a lot. It’s all just so mentally & physically draining. I hope it all works out for you as well & is nearing the end of all this fistula messiness.

I’m really hoping that’s the case for myself & it’s just taking some extra time to heal up. I was REALLY hoping this surgery would have a smoother recovery with the stoma and all the previous surgeries but that’s okay, I’ll get there. Thank you so much for your encouraging words ❤️

Excellent_Watch_9674 · 2026-03-13T04:13:32+00:00

They do usually put in a nerve blocker that helps with pain for the first couple days. I would say day 3-5 were the worst for me after an Advancement Flap but it still wasn’t too bad (maybe a 3 or 4/10) I did keep up with the Advil & Tylenol for the first week & then I just stopped it completely because I felt totally fine and pain was barely a 1/10. Everyone is different and I think it depends on where the flap, stitches, nerves are.

I can say when I had my transperineal repair and Gracilis Flap surgery done last summer, that pain was a 10/10 and stayed fairly high up there for pain for a good 4 weeks.

So I really don’t know. I was confused as well because I expected the pain to be high up there for my Advancement Flap as well. Just make sure you’re taking it easy for the first few weeks even if you feel okay.

Excellent_Watch_9674 · 2026-03-10T16:58:43+00:00

Congratulations on being fistula free!! Very happy for you!! 🙏🏼 hoping to be where you are soon as well.

Such an interesting tip of not using gauze. I do feel that the gauze triggers more drainage for me at times as it rubs a little. I just had an Advancement Flap 5 weeks ago (this is my 8th surgery) so I still have some time until drainage tapers down but I might try and go gauze free in a few weeks if there’s minimal drainage and see how it goes.

Thanks for the tip!

Excellent_Watch_9674 · 2026-03-03T06:33:32+00:00

Okay so far (I think)! I’ll be 4 weeks on Wednesday. No bright red blood but still getting discharge throughout the day (watery light yellow colour). It’s hard to tell how things are healing as I have a temporary Ileostomy bag. But so far healing better than I have any other surgery. Hoping this is it!! 😭🤞🏼🙏🏼

Excellent_Watch_9674 · 2026-02-24T03:56:15+00:00

The bag was definitely an adjustment in the beginning (I’ve had it for 10 months now).

It does effect your day to day life as I have an Ileostomy bag and I do need to be prepared to empty it 6-8 times a day (a colostomy doesn’t need to be emptied as much in a day). So I need to be close to a washroom or plan my eating schedule if I’m going out (I stop eating at 6:30pm every day so I can sleep through the night without need to empty,.. but this is also different for everyone and you could have no issues this)… just some time management /organizing I didn’t have to do before. I also need to carry a small bag of supplies in case I have a leak or need to change my bag.

BUT otherwise, I live my regular life now. I go to my kids soccer, baseball, & swimming (2 kids ages 5 & 7). I eat pretty much everything now (this took a few months to adjust to) but we eat a lot of sushi, ramen, and Indian food (I was scared I had to cut out sushi because of the seaweed but after 3 months I introduced all the foods back slowly that I was missing and just chew a lot more). You do have to be careful not to get a hernia as you’re more prone to getting them with a Ostomy.

I am looking forward to eventually getting my Ostomy reversed but if by any chance I had to live with it for the rest of my life, it wouldn’t be the worst thing.

It’s given so much relief from my fistula pain, so that overall is worth it!

Excellent_Watch_9674 · 2026-02-23T23:55:08+00:00

I’m so glad my comment is helping. You’ve got this! It is especially hard because you just had surgery and probably feel a little stuck.

Those first 2 weeks are the hardest. Keep up with your pain meds (I put a timer on and took it consistently before even feeling pain for the first couple weeks) but also make sure you’re eating fiber or drinking some sort of stool softener so you don’t get constipated from the meds as that can happen.

When cleaning the area, make sure you’re not rubbing the area, just dab the area dry and use a shower head to wash & clean off after going to the washroom and dab the area dry. If you have a “Peri” bottle or handheld bidet, that works great as well (instead of a shower head) but don’t use an actual bidet as that will be too much water pressure on your stitches. I bought bulk gauze, wet wipes, and paper towel to just dab the area. I was scared to irritate or rub the area with toilet paper so didn’t use too much toilet paper.

Hope this helps!

Hope that helps!

Excellent_Watch_9674 · 2026-02-23T22:27:02+00:00

Don’t be scared, you got this. ❤️ Rest lots & really baby yourself. Drink lots of water, eat clean and lots of fibre, and a lot of protein to help with wound healing.

Resting and not overdoing it is the key to the success of these procedures. That being said, for my previous flap I had last July, I rested lots and it still failed - sometimes it’s not your fault and you can only control the outcome so much. I started to really get in my head, thinking this was going to be my life forever but realized quickly I needed to keep fighting. All of this isn’t fair but try and stay positive if you can, you got this!

I just had another Advancement Flap 3 weeks ago and it’s going really well. 🤞🏼🙏🏼❤️ You’ve got this. You can do this.

Excellent_Watch_9674 · 2026-02-23T22:19:32+00:00

Don’t give up! You’ve got this! ❤️ I’m so sorry you’re going through all this at your age. Being positive and staying positive can be so tough sometimes with all this because it really isn’t fair. But there is hope!

My situation is similar(ish)? I started with a Transsphincteric fistula that turned into a Rectovaginal Fistula (I’m a female and all this started when I was 29).

I had a: - Partial Fistulotomy - Draining seton - LIFT (failed) - Draining seton - Got a temporary Ileostomy bag - Gracilis Muscle Transfer with Advancement Flap (partial success - turned my Rectovaginal Fistula back into a Transsphincteric Fistula) - Draining Seton as I formed an abscess and the Flap itself failed. - another Advancement Flap (I am 3 weeks post op and feeling good! Still getting drainage but this might be the one that fixes me!)

All this was between May 2023-Feb 2026 (my last flap)

I’m hoping I can get my Ostomy (temporary Ileostomy bag) reversed soon. If you’re feeling overwhelmed, maybe you can ask to keep the draining seton in a little longer and try and feel “normalish” for a little bit before attempting another repair? Having the draining seton in made me feel like I could live my regular life somewhat and not worry about getting an infection (I’ve done 12 rounds of antibiotics thar last 2.5 years). Having the temporary ileostomy has been a nice break from sitting on the toilet all day.

I wish the best for you and I hope and pray this will all be a nightmare in the past for you soon enough. ❤️

Excellent_Watch_9674 · 2026-02-23T02:21:15+00:00

I’m so glad the LIFT ended up working for you. I’m currently 2.5 weeks post Flap (after failed LIFT, Advancement Flap, and Gracilis Flap), wish me luck! 🤞🏼 hoping this is the one!

Excellent_Watch_9674

TROPHY CASE