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