Anal Fistulas Treatment

Understanding Anal Fistulas

An anal fistula is a small abnormal communication between the inside of the anal canal and the skin around the anus. It usually develops following an infection in one of the anal glands (abscess) that has drained but left behind a persistent tract.

It usually manifests as:

  • Recurrent pain or swelling near the anus
  • Discharge of pus or fluid
  • Skin irritation
  • Occasional bleeding
  • Symptoms that improve and worsen repeatedly

While it can be distressing, anal fistula is a treatable condition, and early specialist care helps prevent complications.

Fistulas are classified and treated based on their relationship with the anal sphincter muscles ( the muscles that provide tone and help with continence).  Surgical treatment options are fine-tuned to find the perfect balance between wound healing and safeguarding of the anal sphincter muscles.

Anal Fistulas Treatment Options

Treatment is always surgical, but highly individualised:  The primary goal of surgery is to improve the quality of life without compromising anal sphincter function

The common treatment options for fistula in ano are as follows

  • Fistulotomy – opening the tract (for simple fistulas)
  • Seton placement – for controlled drainage in complex fistulas
  • LIFT procedure (ligation of intersphincteric tract)
  • Minimally invasive / sphincter-preserving techniques


Most procedures are performed as day-case or short-stay surgeries.

FAQs - Anal Fistulas 

Can an anal fistula heal without surgery?

No, an anal fistula does not usually heal on its own. Surgery is recommended to remove the tract and prevent recurrent infection.

Modern techniques and better understanding of physiology of the pelvic floor musculature help avoid damage to sphincter complex. The type of surgery is carefully chosen based on fistula complexity to minimise risk.  Despite these precautions and careful considerations, a small minority of patients might develop subtle and temporary bowel dysfunction.

Most procedures are well tolerated. Post-operative discomfort is usually manageable with medication and improves within a few days.

Recovery depends on the procedure performed and the extent of the disease. Many patients return to routine activities within a couple of weeks. 

This will depend on the extent of the fistulous disease.  Simple fistulas can usually be managed in a single sitting, however complex fistulas may need more than one surgical procedure to control the disease.

Anal Fistula Treatment & Surgery Locations

Patients seeking anal fistula treatment in Oxford or Banbury can consult Mr Joshua Franklyn, Consultant Robotic General and Colorectal Surgeon, who practises at hospitals across the Oxfordshire region.

An anal fistula is an abnormal connection between the anal canal and the surrounding skin and may cause symptoms including pain, irritation, swelling, recurrent abscesses or persistent discharge. A specialist assessment is important to establish the type, position and complexity of the fistula and to determine the most appropriate treatment.

Patients seeking anal fistula treatment in Harpenden, St Albans and the surrounding areas can consult Mr Joshua Franklyn for specialist assessment and treatment.

An anal fistula can vary considerably in its complexity, and careful assessment is important when planning treatment. During consultation, Mr Franklyn will assess the symptoms and available investigations to determine the nature and extent of the fistula and discuss the most appropriate treatment options.

Mr Joshua Franklyn

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