Fistula after vulva cancer removal

Dear Debs1311,

Thanks for getting in touch, and welcome to our online community.  My name is Lisa, and I’m one of the cancer information nurses on the Support Line.   I’m sorry to hear that you are suffering with an anal fistula at the moment following your surgery.  I’m sure this must be very distressing for you, so I’m glad that you’ve reached out to us for support. 

I can see that you also belong to our Vulva cancer forum.  I hope that you are finding this forum supportive and a way to share experiences.  The Eve Appeal can also offer additional support for you.

Unfortunately, we don’t have access to your NHS medical records.  Therefore, it’s difficult to understand whether the anal fistula is due to the surgery. We would always recommend, however, that for any new, worsening, or changing symptoms that you are experiencing, that you contact your team at the hospital or your GP so they can assess you.  It’s important to ensure that there is no infection or risk of infection following your surgery.

You may experience some problems after surgery for vulval cancer, such as bladder and bowel problems.  As you mentioned, it is important to eat a balanced diet and drink plenty of fluids following a vulvectomy to avoid constipation, as this can delay wound healing if you’re having to strain when opening your bowels.  However, if you have concerns about how diet could impact on your bowels, this can be difficult.  You mentioned you are taking Imodium, and your concern is that it can cause constipation, which is important to try to avoid following a vulvectomy.  It’s a very delicate balance at the moment.  Your gynaecological nurse specialist should be able to advise what would be most appropriate in your particular situation.

I’m sure having to run to the toilet and leaking from your bowels is extremely upsetting, so speaking to your gynaecological team or your GP is important.  The GP may be able to refer you to a dietician or the continence team for additional support.

I know that you enquired about suggestions to help with what to eat, so after speaking to either your GP or gynaecology team, please feel free to get back in touch with us, and we can help further with advice about diet.  

I do hope this helps.  However, we often find that we can help more by exploring these questions over the phone.  You can also speak with the Macmillan Support Line team of experts.  Phone free on 0808 808 0000 (7 days a week, 8am to 8pm) or send us an email.

Best wishes,

Lisa R, Cancer Information Nurse Specialist

Ref/AR/LR