Anus Sewn Shut

[swosborne1]

Hello, debating on whether to have my anus sewn shut. Rectum is gone and only reason they didn’t sew the anus shut during that surgery was to avoid any more incisions. The discharge that comes from that area is annoying. I am active and move around a lot. I also hear getting your prostate exam is an issue with having it sewn shut. Fear of what it would feel like since I’m always on the go. Also heard the surgery takes awhile to recover from.
Not sure what to do. Pros and Cons?

Thanks!

[Diane C]

Swosborne1,

I just posted about my 11/1 extensive surgery. I had my anus REMOVED along with my rectum. Healing and hurts -- bleeding in between the sutures but hear this is normal. I can't really address this except to say that any surgery back there will hurt. Karen recommended a pillow with the cervix area cut out which has been a blessing. Once this all heals, I hope to be a happy camper.

I know that with men, the surgery may be a bit more dicey as there are nerves that can affect sexual function. I hope someone with more knowledge pipes up. Ask your surgeon many questions! Good luck!

Diane C.
2000 MACE for chronic constipation due to dysfunctional anal muscles
2002 Colostomy
2018 Removal of colon, Colostomy, MACE, Rectum, Anus; New ileostomy created

[Andyt]

Mine was sewn shut after my total collectomy . Only problem I had was the crazy long time for it to heal . I had home care after my surgery and the only thing the nurse did was clean and change the rectal area bandages. Almost 2 months. Then another 8 months of being careful with it . It opened up on me once when I kicked a door open ) long story) , and bled for a bit . All in all ,if i could go back and make that decision myself ,I'd say no thanks

[sassie]

Well i avoid any surgery for many reason and yes nasty output from a non working anus is nasty but i found if i do a clean out, as if i was getting a enemia it goes longer between leaking out slime....I could not handle the healing time and sometimes it seems each step you take makes another problem..
Best of luck on your decision.

sassie

[Mysticobra]

Mine was just sewn form the inside. Not removed. Been like this for a bit over 3 years.
I have mucous but it goes no further than the small canal that's left and it's easy to keep clean. Just clean it once a day in a shower or bath. I thought my surgeon was gonna remove everything and am glad she didn't hearing how painful it is. Glad she passed on removing it. No big deal having the mucous thing.
Just like a snotty nose. Lol. Gotta blow it once a day.

As for a prostrate exam. I was told they do it through a blood test instead of manually.

[Diane C]

No question that healing of what was the rectum and anus will take a while. It seems that bleeding stops and starts again. I've perhaps been too active. It's kind of hard "to slow down" when you've a lot on your plate, even at home. I'll be using the gizmo -- the picker-upper -- to avoid so much bending. I've been using Aquacel Extra Ag by Convatec which is a dressing or "packing" material one inserts between the sutures. This is supposed to help healing but I haven't seen that much progress. I have an ointment with silver and wonder if I should use that after cleaning. I'll be seeing the surgeon on Tuesday and will ask.

If this avoids diversion colitis which resulted in much mucous and blood, it'll be worth it. Jury is still out. Good luck!.

Diane C.

[58countrygirl]

I'm overwhelmed by all this Dad had rectal cancer first go was radiation 2 years later it returned and he got colostomy the surgeon removed and sewed all of it
6 weeks post still bloody .Pain is awful, he has a high pain tolerance but this is way more than he bargained for. The smell coming from that area forces us to have windows opened did anyone have problems with this and what did you do to help with the smell he uses pads and changes them at least four times a day

[Button]

58countrygirl:
While it is normal to have “back-end” wound discharge necessitating pads and pantliners, your description of a strong foul odor to your father’s discharge is concerning.

Radiation treatment for rectal cancer, in particular, can leave tissues in the radiation field thin and devitalized.

There is always the concern that your father may have an unidentifed infection or abscess with the drainage and odor that you are noticing. Any low grade fever? General feeling of malaise? Sensation of pelvic pressure?

I would suggest to your father that he call his surgeon to bring these concerns to the surgeon’s attention.
Karen

[Diane C]

Definitely see a surgeon I know the procedure is more challenging with those who’ve had cancer. I did not – there.

As stated, my surgery was Nov 1. I was in the hospital over a week and then at a supposedly skilled (NOT!) nursing care facility for 10 more days but in retrospect realize I needed that care, PT, OT, food, etc. although the quality of it was rather poor (do research skilled nursing care – good facilities DO exist) as I'm single and could not have handled it all solo.

Then home where I managed pretty well and washed and “dressed” the anal area with a dry dressing of Aquacel silver and bandage to heal it. It did bleed – I was used to it -- but the bleeding became minimal over time and I just kept up the routine. However – and this seems common – I developed a post-surgical wound about a month later where the anus did not fully close. That required a home health nurse coming to dress the wound and trips to a wound clinic every 2 wks to check progress. There is no odor that I can sense on the pad that the visiting nurse uses or it must be very slight. I did have an infection and needed antibiotics but noticed no odor and am sensitive to that.

As Button/Karen has emphasized, patience is imperative as wound management is a whole new ballgame. Communicating with pals, meditation, focusing on the positive , doing some nice things for yourself – a huge help as saccharine as it may sound.

Wounds can take a long time to heal – decrease in size – and then open up. Now it’s April and the nurse is still coming and I may need a non-surgical “bovine graft” (a 6-minute procedure) to heal the wound – I hope. The rest of the tissue there is quite thin. I’m careful although I hope to swing dance but will do what I can to prevent tearing of the tissue there. I do worry somewhat about it. It’s getting a bit stronger but I was shocked by how fragile the tissue feels. I’m taking Juven (has collagen and other ingredients to heal the wound and plan to continue to take collagen when it’s all healed) and it’s helpful to skin, hair, nails. I’ve also been told to consume 120 g. of protein daily – not easy. I’m trying and used a protein mix but the inulin in it caused much gas and distension. There’s very little pain there now, a slight discharge, I’m pretty active, and I’m VERY relieved not to have to deal with the cramping and frequent discharge.

So all involved require much patience. Once the surgery began healing – despite the wound --– I didn’t find the pain immense and even only relied on Extra-Strength Tylenol as more powerful medication can slow the digestive tract and I didn’t want any blockages. Pain meds ARE useful and necessary after initial surgery.

Consultations with an experienced surgeon: mandatory and perhaps several to understand the whole process. I visited the Cleveland Clinic a while back and was told this surgery takes a real “whack out of the body.” Agree, esp with complications. Bottom line – glad I did it and it is over. Hope the area does not rip again given the fragility of the tissue. I am not a fan of more surgery in the future.

Good luck.

Diane C.

[Button]

58countrygirl:
To be clear . . .

Your father’s symptoms of heightened pain, copious “back-end” discharge soiling multiple pads a day, and an offensive foul smelling discharge are all concerning for a possible abscess or brewing infection.

I highly suggest that your father contact his surgeon ASAP.
Karen

[58countrygirl]

I've had dad in the emergency room yesterday the blood test and everything revealed a UTI as they did Nick the urethra during surgery and at week six he is still wearing a catheter We have an appointment tomorrow to see the surgeon addressing all of this I really appreciate everybody's answers never thought about an abscess but that makes sense but I would've thought it would've given indication in the white blood cell count now I know from the responses that the smell we are experiencing is not normal

[Button]

I've had dad in the emergency room yesterday the blood test and everything revealed a UTI

We have an appointment tomorrow to see the surgeon addressing all of this

but I would've thought it would've given indication in the white blood cell count now I know from the responses that the smell we are experiencing is not normal

Your father has a more intricate medical history than the “norm” so it is going to be important for him/you to know what is usual and customary for your father in terms of his health baseline and to make sure that your father’s unique health profile is not lost or minimized in this era of fast-track medicine and generalized standards of care.

Case in point: Your father may have a degree of immune suppression from his prior chemotherapy infusions (cytotoxic medications as well as glucocorticosteoids). If this is the case, your father’s baseline white blood cell laboratory findings would be lower than population norms which define “normal” range values. If your father’s new normal WBC baseline is low then laboratory values suggestive of an infection will be missed.

I can use myself as an example. I am immunosuppressed due to corticosteroid dependency. I will show a low WBC count on a routine blood draw. This can be problematic if I am in an ER that does not know me. When I have an acute infection brewing, my WBC coint will rise . . . . but it may rise to just within a standard normal range. A physician who does not know my health profile and who relies only on printed laboratory results can easily and mistakenly say that I am fine and A-OK. My WBC count will not rise as will the WBC count rise of someone who is not immunosuppressed.

All to say . . . It will be important to interpret blood chemistry markers for a possible infection/abscess with a degree of suspicion and caution. If your father is immunosupressed from his prior cancer treatments, this will affect how laboratory values are interpreted - to be interpreted correctly. You may need to be a voice to bring attention of your father’s history and what is normal/customary for him.

Also, for any laboratory value “low normal” and “high normal” results can be symptomatic for a given person. The cut off values for “normal” are based on aggregate population statistics. As an example, where a .10 difference separates “normal” from “abnormal” it is reasonable to expect that someone with a lab value on the line will be symptomatic. It is rarely a definitive black/white binary situation where a “normal” lab value equals full health and a “low or high normal” laboratory value equals an unraveling of health/unwell.

Ask questions of your surgeon tomorrow. And keep asking until your concerns are answered.
Karen

[Rchodos1]

Just to add: for the prostate exam, a trans perineal biopsy under anesthesia can be performed. Best of luck ...

[nickolas]

Okay I am a female so my situation may be different. I too am sewn up back there. Rectum 100% gone. I have NOT had any problems describes here. Yes I had pain back there for a few months following surgery (broken bone type pain), totally gone in a few months. I had surgery in August, towards the end of December, it felt funny back there. Called the office during holiday hours, my surgeon called me back. Because I was not in pain, she would see me after the holidays, everything was fine. I was concerned I was opening up back there. Surgeon assured me I would know, pain wise. I've never passed blood back there, never passed mucus or anything else. Due to pain back there, please follow up with your surgeon to make sure there is no infection.

I was once told, any pain lasting 2 weeks or more need medical attention. That has been my golden rule.

Nickolas