What is normal vaginal drainage after rad?

ACinNC

I would be interested to know how radiation affected vaginal discharge or drainage in ladies treated for AC.  I am hoping to gauge if what I have is normal or coming from a rectovaginal fistula.  I am 5 months out from treatment. Prior to starting treatment I had a temporary colostomy placed due to the fistula. Going back a couple of months before the AC was diagnosed I started needing to wear pads due to some drainage but I am a little fuzzy when I try to think of what it looked like.  That was until I started having stool come out vaginally.  This occurred a day after surgery for what I thought was a hemorrhoid which of course turned out to be an external extension of the anal cancer.   

Mine was 3B and 5.5 cm.  As radiation progressed, the vaginal drainage became very heavy and yucky which I believe was the dead tumor tissue coming out. My tumor was into the wall of the vaginal and no doctor can tell me if the drainage was from walls of vagina or coming through the fistula.  A çolorectal surgeon located the fistula but said it was very small.  Even so, he doesn't think it will heal and wants to do surgery using a gracilis flap.

My drainage is now still heavy enough that I have to wear pads. But it's not yucky, just slighty yellow and mucousy.  I have mucus come out rectally because I have a loop colostomy and mucus comes through the inactive portion of the stoma into the rectum.   I'd like to get rid of the colostomy but can't until the fistula is healed.  I have been hoping to prove the surgeon wrong and have the fistula heal on its own but the continued drainage makes me think it is still there.  Do any of you have drainage like this? 

BTW, my PET scan last month  came back showing no tumor and the nodes no longer avid. So I am at the point of needing to decide on the surgery.     Some days I think what the heck, I'll just live with the colostomy because I have accidents with the mucus slipping out without me trying.  And then there's the real possibility of recurrence and I would end up with a colostomy anyway. Other times I feel like taking a chance. But first I have to get past this fistula.  So if anyone has had something similar I would like to hear.   

Mollymaude

Drainage

I don't remember having any mucus like discharge vaginally. I did have some blood from the vagina when radiation burns were at their worst and still bleed easily from my vagina. I did and still do have mucus as rectal discharge. There have been several posts about fistulas so I hope those posters can answer your question.  Congratulations on the great results from your PET scan. You have some really tough decisions about the colostomy reversal, please keep us posted. 

eihtak

ACinNC....

Hi, I wish the answer for you was more clear, but firstly "CONGRATULATIONS" on completeing this treatment...we here all know its not easy!

I do not have a fistula but otherwise much like you except that I completed my treatment almost 6 1/2 years ago for Stage 3b anal cancer. Due to size and location of my tumor, I too had a loop ostomy prior to starting treatment. It was to be reversed sometime after when healed, but I have decided against that due to severe radiation damage and the likelyhood of bowel incontinence. I made that decision after seeking a second opinion and advice from a specialist at a larger medical center than where I received treatment. I have adjusted well to ostomy life and really have little to complain about along those lines.

But the mucus discharge!! Yes, I have that daily. I am sorry I do not remember whether or not it was more or less in the six months after treatment than it is now, but it seems it must have been. What I have now reminds me more of sinus drainage but thicker, lol. I do also have what you described in relation to the loop ostomy and have learned that is quite normal. I am in a couple ostomy support groups and it is sometimes referred to as "whale snot", haha!! I wear a pad 24/7 and like other things, it has just become my normal. 

I think it is quite common to shed cells, tumor, tissue, that may be as you say "more yucky" during that first year. As to treatment of the fistula, hopefully someone else will chime in. If left untreated I imagine it could get worse, but on the flip side, how well will radiated tissue respond to surgery???

I am happy to hear your recent scan was good news!! Yay, you have something to celebrate!

Please stay in touch as you proceed, and let me welcome you to this amazing site. Know that you will be in my thoughts and prayers for health as you move forward.

katheryn

LindaBaehr

Fistula

I too have a fistula which formed after my first round of chemo.  Prior to radiation my colorectal surgeon suggested a Seton rather than a temporary colostomy.  That held the fistula open during treatment.  Unfortunately, the damage from the radiation has made healing likely impossible.  I still have mine 15 months post-treatment.  In addition, my doctor has told me that the surgery to fix it is very involved and only about 50% effective.  

I take a daily antibiotic to prevent UTIs due to cross contamination.  Yes, I have discharge, expecially when my diarrhea is particulary bad.  I can also pass gas through the fistula .  I'm not sure if I could make a party trick out of that or not.  LOL.  

With the low rate of success for that repair surgery, I'm not sure I even want to chance it.  

 

UGH

ACinNC

eihtak said:

ACinNC....

Hi, I wish the answer for you was more clear, but firstly "CONGRATULATIONS" on completeing this treatment...we here all know its not easy!

I do not have a fistula but otherwise much like you except that I completed my treatment almost 6 1/2 years ago for Stage 3b anal cancer. Due to size and location of my tumor, I too had a loop ostomy prior to starting treatment. It was to be reversed sometime after when healed, but I have decided against that due to severe radiation damage and the likelyhood of bowel incontinence. I made that decision after seeking a second opinion and advice from a specialist at a larger medical center than where I received treatment. I have adjusted well to ostomy life and really have little to complain about along those lines.

But the mucus discharge!! Yes, I have that daily. I am sorry I do not remember whether or not it was more or less in the six months after treatment than it is now, but it seems it must have been. What I have now reminds me more of sinus drainage but thicker, lol. I do also have what you described in relation to the loop ostomy and have learned that is quite normal. I am in a couple ostomy support groups and it is sometimes referred to as "whale snot", haha!! I wear a pad 24/7 and like other things, it has just become my normal. 

I think it is quite common to shed cells, tumor, tissue, that may be as you say "more yucky" during that first year. As to treatment of the fistula, hopefully someone else will chime in. If left untreated I imagine it could get worse, but on the flip side, how well will radiated tissue respond to surgery???

I am happy to hear your recent scan was good news!! Yay, you have something to celebrate!

Please stay in touch as you proceed, and let me welcome you to this amazing site. Know that you will be in my thoughts and prayers for health as you move forward.

katheryn

Eihtak, 

Eihtak, 

Besides what we know is normal mucus from the colostomy that comes out  though the rectum, do you also have vaginal mucus discharge?  I know you don't have a fistula but just wondering if discharge or drainage from vagina occurs in those without a fistula after radiation which affects the vagina. 

Some people with an ostomy adjust well as you have.  But I have never bonded with mine.  I can'tell give it a pet name as some do. It is a constant annoyance and because it is very prolapsed, changing the flange takes much longer than normal.  I have to lie down and keep pushing the stoma back in until I can apply a new flange.  Not  fun.  I understand prolapse is not unusual with loop colostomy . Did you consider having yours changed to the permanent way?  If I keep the colostomy I will at least get it revised to get rid of the prolapse.

 

eihtak

ACinNC said:

Eihtak, 

Eihtak, 

Besides what we know is normal mucus from the colostomy that comes out  though the rectum, do you also have vaginal mucus discharge?  I know you don't have a fistula but just wondering if discharge or drainage from vagina occurs in those without a fistula after radiation which affects the vagina. 

Some people with an ostomy adjust well as you have.  But I have never bonded with mine.  I can'tell give it a pet name as some do. It is a constant annoyance and because it is very prolapsed, changing the flange takes much longer than normal.  I have to lie down and keep pushing the stoma back in until I can apply a new flange.  Not  fun.  I understand prolapse is not unusual with loop colostomy . Did you consider having yours changed to the permanent way?  If I keep the colostomy I will at least get it revised to get rid of the prolapse.

 

ACinNC...

Hi, to be honest it is sometimes hard to tell if the drainage is from the vaginal area, but at least some does seem to be. The mucus (almost like a plug) from the rectum seems to occur most often in the morning and usually prior to having output in the bag. The vaginal discharge is lighter and just kind of gradual throughout the day I suppose.

I too had a very large prolapse but it was during radiation. It almost filled the entire bag and was so very difficult to keep the bag on or to prevent leaks. I was hospitalized and then admitted temporarily to a skilled nursing facility as I too needed much help changing my appliance. The plan was to have the prolapse surgically fixed when done with treatment, but by the grace of God it repaired itself within two weeks of finishing radiation. I can relate to the constant pushing it back in that you do and I am so sorry you are dealing with this. Although I have adjusted well, I was never like some who give "pet names" either or talk jokingly of this as if its some kind of friend. Its a part of my body and serves a purpose for which it functions well, thats it. Keep in mind I'm going on 7 years with such so it really has become routine for me, it wasn't always.

Would I have complete APR surgery? Probably not at this point. When I made the decision to keep the ostomy as permanent it was considered, but then 1 year later I was dx with breast cancer and a couple years ago anal cancer mets to my lung. Both required surgery and chemo again for the lung. Since I am feeling good, active, and enjoying life, I'm not going to make any changes unless I need to. APR surgery is a bit more involved and requires more healing time so do your research before you decide. The prolapse can likely be fixed without doing APR as there are a couple people in my support group who have had this done. (One has a loop, the other not) Although loop ostomies are done with the potential to be reversed, they are as long lasting and functioning as other methods as well, so it is not necessary in most cases.

I sure wish I could be more help with the fistula, every surgery comes with the risk of a condition being actually worse or the dx of something new because of, yet if you are otherwise healthy, it may be what you need to improve the quality of life right now...we all deserve to have that!!

Please stay in touch, I'm thinking of you!

katheryn

 

ACinNC

LindaBaehr said:

Fistula

I too have a fistula which formed after my first round of chemo.  Prior to radiation my colorectal surgeon suggested a Seton rather than a temporary colostomy.  That held the fistula open during treatment.  Unfortunately, the damage from the radiation has made healing likely impossible.  I still have mine 15 months post-treatment.  In addition, my doctor has told me that the surgery to fix it is very involved and only about 50% effective.  

I take a daily antibiotic to prevent UTIs due to cross contamination.  Yes, I have discharge, expecially when my diarrhea is particulary bad.  I can also pass gas through the fistula .  I'm not sure if I could make a party trick out of that or not.  LOL.  

With the low rate of success for that repair surgery, I'm not sure I even want to chance it.  

 

UGH

Linda,

Linda,

I know the unencouraging stats on repair but the gracilis flap offers the best chance since it is bringing it's own blood supply with it.  I met with the plastic surgeon who would work with the çolorectal surgeon and the PS has a lot of experience with reconstructive surgery in radiated tissue so I feel like they could give me the best chance of success. I just don't know if this 62 y.of. body is up to more assault on it.  The anal cancer was my third different cancer. With other health issues, I should just let well enough alone. My radiation once doesn't want me to consider surgery until after a CT scan in January just to make sure that at that time there is no recurrence. But I am torn between wanting something to be normal again and just trying to accept the new normal.

It is helpful knowing that your fistula did not heal on it's own.  My rad onc  thought mine  had a chance once the tumor was gone.  But I tend to think this drainage means it is still there. 

Passing gas through the fistula is weird.  As is passing stool through it. For that reason alone, I would rather have the colostomy.

I appreciate all the input.

mp327

ACinNC

I have not experienced a fistuala, so have very little to offer here.  I did not experience vaginal discharge, that I remember, during my treatment.  I do have rectal mucous sometimes.  I am 9 years out of treatment.  My biggest concern with the surgical repair of a fistuala would be healing, due to the radiation treatment.  I hope you and your doctors can sort this out and decide on a plan that is best for you.  I send you all good wishes.

PegSue

ACinNC

I am not quite 5 months post treatment as well and have had vaginal drainage that started towards the end of treatment.  It has slowed down a bit since initially but I can't go more than a few minutes without a pad.  I was worried that I had developed a bladder-vaginal fistula but the doc didn't think so and belived that the discharge was due to burned tissues sloughing away.  I'm hoping that it doesn't last forever.  I just keep reminding myself that radiation is the gift that keeps on giving.  Hang in there and prayers for you!