# A pain in the butt like literally



## ttran037 (May 21, 2013)

Hey everyone,

So I'm currently 29 years old. This might be TMI but at this time all me sense of dignity is gone lol. So I developed a perianal abscess about 2 months. It was the worst experience of my life. I've had numerous of mountain bike injuries but nothing comes close to that. Anyways fast forward now, I got in to see a colorectal surgeon yesterday due to mild discomfort and residual pain. Sadly, it turns out that I have a fistula. He actually recommends surgery. I'm hoping that its superficial and just requires a fistulotomy. 

First thing I asked him was when can I get back on the saddle. He said earliest is 2 weeks, latest is 12 weeks. As we all know, I don't think I can last more than 2 weeks off of the bike ahaha. 

I am actually a general physician myself. On the one side, I'm thinking I should get it over with and really fistula can't be treated unless surgery is performed. Furthermore, its better to do it earlier. On the other hand, I'm feeling pretty normal right now, I want to just live with it and delay surgery. Not to mention, I want to go out ride. And god all the horror stories online about the post-op care after a fistulotomy, I shouldn't have read forum on it.

Just wondering if anyone went through something like this before?


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## Deetz99 (Mar 22, 2021)

Hi there, sorry I cant be of any help but Im going through the same thing right now. Was wondering if you found a solution? The surgeon I went to gave me antibiotics to treat the fistula and with the follow up he didnt recommend surgery. Just said to go back if it gets worse. Even if I could go biking it would still be extremely uncomfortable, even long walks it gets irritated. Ive read online fistulas cant heal themselves without surgery but that people do manage to live with them long term. Hoping you can provide any insight. Thank you!!


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## ttran037 (May 21, 2013)

Deetz99 said:


> Hi there, sorry I cant be of any help but Im going through the same thing right now. Was wondering if you found a solution? The surgeon I went to gave me antibiotics to treat the fistula and with the follow up he didnt recommend surgery. Just said to go back if it gets worse. Even if I could go biking it would still be extremely uncomfortable, even long walks it gets irritated. Ive read online fistulas cant heal themselves without surgery but that people do manage to live with them long term. Hoping you can provide any insight. Thank you!!


Hey man,

So I held off on the surgery for a couple of months after. However, it kept coming back and really impacted my quality of life. It affected work and just going out in general. While after the initial event, the pain did improve, the drainage became bothersome. So I eventually went to have the surgery. The surgery went really well. The surgeon told me that the fistula tunnel was very superficial and the surgery took only 15 minutes. I actually did not have any pain the following thereafter. I had more issue with nausea from the anesthesia. I actually went riding the week after. Ever since then I have not had any issues. Looking back, I really asked myself why I waited so long.

I think the part that bother me most with the entire process is not knowing what will happen after surgery. I was concerned about getting a seton or having issues with bowel control. It's hard for the surgeon to know what surgical treatment is needed until they find out how deep the fistula is. However, I think the best advice I can give you is if you have tried the treatment that they recommend but doesn't improve and it is affecting your quality of life, you should consider to reconsult with them. I'm not sure why they wouldn't recommend surgery as your case might be different than mine.

I hope this help and hope that your symptoms improve as I can say that it wasn't a pleasant experience


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## Deetz99 (Mar 22, 2021)

ttran037 said:


> Hey man,
> 
> So I held off on the surgery for a couple of months after. However, it kept coming back and really impacted my quality of life. It affected work and just going out in general. While after the initial event, the pain did improve, the drainage became bothersome. So I eventually went to have the surgery. The surgery went really well. The surgeon told me that the fistula tunnel was very superficial and the surgery took only 15 minutes. I actually did not have any pain the following thereafter. I had more issue with nausea from the anesthesia. I actually went riding the week after. Ever since then I have not had any issues. Looking back, I really asked myself why I waited so long.
> 
> ...


Thank you so much for the reply.

This is actually my second time with a cyst, the first time I had an open-excision with packing daily, which healed fairly well. I agree it's very unpleasant to say the least.

Though it came back about a year later but Ive been living with it with minor inconvenience for years until just a few months ago. Where I developed a fistula. It got pretty bad I would say before the antibiotics. Now its kind of okay but Its definitely impacting my life, the surgeon I saw basically said it's not that bad and theres no point in doing any procedure until it's much worse. Even though it's draining semi-regularly and I can't walk for more than 30mins straight without it becoming super uncomfortable.

I'm currently on a wait list to see a specialist here so I'm hoping they can help me get back to normal asap.

Cheers and thanks again!


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## Truckeemtb (Dec 10, 2006)

I am sitting in the similar situation (actually I can't sit at this time). I had a abcess end of May and have now had 3 draining surgeries and a seton. No local doctor can help. In non winter months I typically ride 3 to 7 days a week. Trying to find a long term solution. It's been brutally painful. Trying to find a doctor that can help me get back to riding. My 3rd surgery was July 16th 2021.


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## Deetz99 (Mar 22, 2021)

Is this confirmed pilonidal disease or a regular abcess?? Theres a website called pilonidal.org with a lot of helpful information, they have a "find a surgeon" tool in the "treatments" page. You will want to see a specialist for sure as this disease is somewhat rare and most gps and general surgeons arent trained to treat it properly. There is also a fb group called pilonidal support group or something like that and the people on there are super helpful as well.


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## Deetz99 (Mar 22, 2021)

Truckeemtb said:


> I am sitting in the similar situation (actually I can't sit at this time). I had a abcess end of May and have now had 3 draining surgeries and a seton. No local doctor can help. In non winter months I typically ride 3 to 7 days a week. Trying to find a long term solution. It's been brutally painful. Trying to find a doctor that can help me get back to riding. My 3rd surgery was July 16th 2021.


Is this confirmed pilonidal disease or a regular abcess?? Theres a website called pilonidal.org with a lot of helpful information, they have a "find a surgeon" tool in the "treatments" page. You will want to see a specialist for sure as this disease is somewhat rare and most gps and general surgeons arent trained to treat it properly. There is also a fb group called pilonidal support group or something like that and the people on there are super helpful as well.


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