Anal Fistula
Abnormal structures that should not normally be present in the body can develop due to certain health problems. These structures may allow bodily fluids to pass into unwanted areas and can lead to various diseases. One such condition is the development of a fistula.
A fistula is an abnormal connection between a hollow organ or cavity and another tissue or the skin for various reasons. This connection causes fluid to pass between the two areas.
An anal fistula (or perianal fistula) is the formation of an abnormal channel between the intestinal tissue inside the anus and the external skin. It usually develops as a result of an untreated or late-drained anal abscess (a pus-filled, inflamed swelling in the anus) bursting both into the intestine and toward the skin. The most common complaint is a persistent or intermittent discharge from a non-healing opening around the anus. This condition can also occur together with recurrent abscesses.
How Is Anal Fistula Diagnosed?
The diagnosis is usually made based on the patient’s complaints and the doctor’s physical examination. However, to more clearly determine the location, extent, and relationship with muscles of the fistula, some imaging methods may be needed. These include:
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Fistulography (contrast X-ray)
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MRI Fistulography (magnetic resonance imaging)
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Anoscopy / Rectoscopy (camera examination inside the anus)
How Is Anal Fistula Treated?
Treatment of anal fistula is always surgical. If there is an active infection (abscess), it is first drained, and definitive surgery is performed after the inflammation subsides.
Treatment methods include:
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Complete removal of the fistula tract
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Closure of the internal opening with sutures, tissue flap, or clips
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Seton application (special thread or rubber band)
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Use of biological glue or fistula plug
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Internal burning of the tract using laser, radiofrequency, or electrocautery
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Endoscopic fistula cleaning (fistuloscopy)
During surgery, the muscles controlling the anus may be damaged. In such cases, temporary or rarely permanent issues with gas or fecal incontinence can occur. To minimize this risk, surgeons act very carefully during the operation.
Does Anal Fistula Recur?
Anal fistula can recur in some cases after surgery. Although various modern and traditional treatment methods have been developed, there is still no 100% guaranteed solution.
However, if left untreated, the infection may become chronic, the fistula can enlarge, and become more complex. Therefore, despite the possibility of recurrence, treatment is important.
The Seton method is often preferred because it protects the anal muscles and reduces the risk of recurrence. Less invasive methods can also close and heal the fistula tract.
With new technologies, modern methods such as internal burning of the fistula (laser, RF, electrocautery) and endoscopic treatment can provide painless and faster healing, with success rates comparable to traditional surgeries.
TREATMENTS
