Fistula - #9463

Dear Neha, I understand how challenging this has been for you, and I appreciate you sharing the details of your case. Since you have undergone a fistulotomy followed by plastic surgery and stoma placement, your current symptoms—itching, burning sensation, and difficulty urinating—are likely due to a combination of post-surgical healing, possible infection, and local irritation. Since you’re suspecting a UTI, it’s best to get a urine routine and culture test done to confirm the infection. If positive, a targeted antibiotic course will help. In the meantime, staying well-hydrated and using a urinary alkalizer (like Cital or Alkasol) may help ease the burning sensation. The vaginal itching and burning could be due to post-surgical irritation, infection (bacterial or fungal), or reaction to medications or hygiene products. A vaginal swab culture will help identify if there’s an infection that needs treatment. In the meantime, keeping the area clean, avoiding scented products, and using probiotic supplements or yogurt to maintain vaginal flora may be helpful. For your long-term treatment plan, the main focus would be on: • Healing and Monitoring the Rectovaginal Fistula Site – Your surgeon will likely assess the stoma regularly, and once healing is sufficient, they will discuss stoma reversal surgery. • Preventing Future Infections – Maintaining good hygiene, managing any residual inflammation, and ensuring proper nutrition for optimal healing. • Pelvic Floor Rehabilitation – If needed, pelvic physiotherapy can help restore strength and function in the area post-recovery. I strongly recommend following up with your colorectal surgeon and plastic surgeon for a proper evaluation of healing and discussing the timeline for stoma reversal. If the symptoms persist, a gynecologist consult might be needed to rule out any local infections or irritation.