I’m in the tightening process of the cutting seton. The last tightening was Monday, and I have to say it is the worst pain I have ever experienced in my life. I’m overwhelmed, trying to figure out what I can do to relieve the pain. Sitz baths used to help, but not at this point. Sitting in water just burns and is intolerable. My CRS said he’s hoping it will just fall out this week. Otherwise, I have to go get it tightened again on Monday. He ordered me a 3 day course of Toradol and I’ve been taking Tylenol as well, but can anyone give me some advice on how to get through this? TIA
The seton really hurts, but after it falls out, it’s like you never had one, try to be patient with the pain, these things work.
Update: The pain has been so bad that I’ve barely slept. I’ve been taking Toradol and Tylenol together, which has only been effective for about 5 hours at a time. The pain has been shooting down my legs and into my pelvis. On that note, I made an appointment with my CRS today. The seton was loosened. He wants to follow up in 2 weeks and possibly take me back to the OR in 1 month for a fistulotomy or an advancement flap (no idea what this is?) since I can’t tolerate tightening of the seton anymore. I’m so scared and frustrated. My family and employer are frustrated. I have no idea what to expect at this point.
The cutting seton according to the most up to date research and my anorectal surgeon in Toronto Mount Sinai hospital tells me is an outdated surgery. I got a regular loose seton for 3 months it was not painful at all just uncomfortable. I recently got a LIFT and waiting to see the results of that. Keep us posted please. Good luck.
I was in a similar boat, the pain for me was excruciating, especially after my daily bowel movement. My CRS let me go on short term disability because I was in no state to work. Pain meds that worked for me were tramadol. Worked better than Vicodin I also got. I always made sure to try and take one roughly 30mins before I had to go to the bathroom. But in reality, I still spent about 2 hours after in what felt like endless pain laying on the couch until it finally subsided. Also, my CRS did tightenings every 2 weeks, not weekly.
The Toradol worked for me. Turned off the pain like a light switch.
I got a fistulotomy instead of a seton. The surgery was like a month and ahalf ago and its half healed.
Kinda glad i didnt get the seton
Hi! I know you posted this quite some time ago, but I was wondering how you got through all of this? I had my fistula surgery last week and had a cutting seton put in. I have my first tightening/recheck on Tuesday and I’m terrified.
looking for any and all advice. How are you doing now? Have you had any reoccurrence, or did the cutting Seton work for you and eliminate the fistula nightmare?
I’m right there with you. I’ve had one tightening of my cutting seton and it was the most painful thing I’ve ever gone through, no general anesthesia was offered until after they’d tightened it…and then they gave me a shot directly in the affected area to relax the sphincter, not before like they probably should have. I’m so sorry you’re going through this but if you need someone to commiserate with, feel free to DM me. I’m quite scared for the very-real possibility of a second tightening.
How were the results of the LIFT? I just had that done 2 days ago.
How did it work out for me? Is your fistula gone? Any further issues? Are you fully continent?
hey. same procedure. I had filostomy and cutting seton was placed too. I’m on my Day 7 now. Went to my surgeon today and he tightened the seton. It was painful. 10/10 pain but after some time, pain went down. My only problem is its too painful when I poop. There’s also blood after i poop. Wht about you?
sorry just saw this. my lift failed. I had to do a fistulotomy.
Literally on my way to my first tightening appt! I’m definitely scared about the pain so I took three hydrocodone and three ibuprofen. So I’m hoping that helps a bit… I currently don’t have any blood when I go to the bathroom, and also not much pain at all, but I’m sorry to hear that’s how it’s going on your end! This whole situation is a really terrible nightmare and I hope it’s over soon for both of us. Reddit has been really helpful in somewhat knowing what to expect. My surgeon had me wait two weeks for my tightening appointment, so not really sure what to expect pain wise. I know it’s going to hurt based on what everyone else says. You’re like the fifth person that said it’s 10/10 
. I’ll let you know how it goes!
Day 1 after first tightening! Pain during tightening wasn’t too bad, but this morning woke up with ALOT of soreness. Had my first BM and a tiny bit of blood but not much and it wasn’t too painful especially considering I’m still constipated. I’m taking a fiber supplement, stool softener, and I eat a lot of fiber too, but it’s not enough apparently. I hope your pain has gone down and you’re managing ok! Can’t wait for this to be over! My CRS is fairly conservative with the tightening so we are only doing a tiny bit at a time to avoid incontinence issues. Fingers crossed I only need a couple more appointments!
How are you doing now? Did your fistula go through a lot of muscle? Are you continent?
hello. during BM pain now is manageable and no blood in my poop. I consulted another doctor which is a colorectal surgeon. He suggested that after 6 weeks from my operation, i will be operated again. He said the remaining muscle will be cut. He said the cutting seton tightening is old school. Im conflicted whether to wait until the cutting seton cuts thru all the remaining muscle (suffer every tightening) or undergo for another operation (everything will be over) I would like to hear your thoughts.
Hi! During my tightening appointment, I talked to my surgeon about the fastest way to get through this nightmare. She said some surgeons will cut directly into this sphincter muscle, but that has a very high rate of causing incontinence, so she doesn’t do that. I completely trust her and she has many awards for being a CRS, and has been doing this for over 20 years! She has always taken the slow/safe route to avoid that. My next tightening procedure is on June 11, three weeks out from my last one. I know every surgeon has their own way of doing things…but from what I understand about all of this, and what was explained to me, it seems the best and safest option is to slowly go through the cutting seton process/tightening every few weeks until it comes out. I hope this helps!