Patient Information from CSSANZ website
What Is A Fistula?
An anal fistula is an abnormal track (“tunnel”) between the internal lining of the anus and the skin outside the anus. A fistula may develop after drainage of an anal abscess but may occur spontaneously. Discharge of pus may be constant or intermittent as the external opening on the skin may heal temporarily.
Is A Fistula Related To Cancer?
No, a fistula is not related to cancer.
Is A Fistula Related To Other Diseases?
Most fistulae are the result of infections in an anal gland. However patients suffering from inflammatory bowel disease (Colitis and Crohn’s disease) are more likely to develop anal abscesses and fistulae.
How Is A Fistula Treated?
Surgery is needed to cure a fistula. The course of the track between the anus and the skin has to be identified and exposed. This track may be treated in one of three ways according to its complexity.
- Fistulotomy opens the length of the track to the skin’s surface allowing the open wound to heal slowly. Some sphincter muscle is divided. This is the most common treatment employed.
- A Seton is a loop of flexible material placed along the track to maintain drainage for a period of time.
- Fistula repair closes the internal opening of the track and preserves anal sphincter muscle. This is a more complex operation.
- Examination under anaesthesia may be necessary to assess the process of healing. Most operations for fistulae are performed in hospital but small fistulae can be managed in Day Care Centres.
Anal fistula can be a difficult and frustrating condition for a patient, as healing rates are variable, and there is often the need for several surgeries in the situation of a complex anal fistula. As a patient, it is important that you receive a clear description of the likelihood of healing from your surgeon. Please discuss any concerns around this with your surgeon, in particular if the condition is affecting your mood and your ability to carry out your normal daily activities.
Anal Sphincter Control After Surgery
Fistulotomy divides a varying depth of anal sphincter and this may result in some weakness of the muscle. The effect on continence will depend on the anatomy of the fistula and the amount of intact sphincter remaining after surgical treatment.