Digestive Pelvic Floor Centre

"Care for your gut   Check on your butt"

Video Assisted Anal Fistula Treatment + Over the Scope Clip (VAAFT + OTSC) / Seton Insertion

Pain
It is within expectation that you experience mild to moderate pain in the first 2-3 days after the surgery. Regular anti-inflammatory medication and paracetamol as per your doctor’s advice will assist pain control in the first week. If you require stronger analgesic, please speak to your doctor for a prescription. 

Swelling
It is common to notice fair amount of swelling around the wound after surgery. 

Bleeding
Mild bleeding and discharge from the wound normally occurs especially after silastic seton (rubber band) insertion. It is important to ensure wound cleaning after bowel movements. You can use wipe or water to clean, try to avoid repetitive wiping with scratchy toilet paper as this might cause irritation to your skin. Do not apply any ointment over the wound as this might increase the risk of infection. Using sanitary napkin changed twice a day will prevent skin irritation and fluid stain on the underwear.

Bowel Function
Use your bowel only when you have a strong sensation for bowel movement. Do not suppress your urge due to the fear of pain. You should keep your stool soft to avoid excessive straining on toilet, this can be achieved by:

  • Adequate fluid intake

  • Adequate soluble and insoluble fibres

  • Engage a good sitting posture on toilet 

  • Use the toilet no more than 5 minutes

  • Use movicol if you are taking strong analgesia (Strong analgesia can slow down your gut which can cause hardening of stool). DO NOT use fleet enema. 


Sitz Bath
A 10-15 minutes twice daily warm salt water (Sitz) bathing will provide a soothing effect to your bottom in the first week after the procedure. Dissolve a handful of salt in the hot/warm water of a shallow bath and sit there for 10-15 minutes

Activity Restriction

  • Heaving lifting

  • Participating in water sports or going to the beach


You will require to follow up with your doctor after the procedure to discuss the further management of the fistula.