Anal Fistula Treatment

An anal fistula usually requires surgical treatment in order to heal. An anal fistula may often pass through the muscles surrounding the anus. These muscles are important for maintaining continence. It is very important that when fistulae are treated this muscle is not damaged excessively so that a patient has trouble controlling their bowels.

Fistula surgery can be difficult and some patients may require repeated procedures in order to get their fistula healed.
Fistula surgery requires a general anaesthetic. There are several surgical options that can be used:

Seton Drainage. Simple drainage involves the insertion of a drainage tube known as a seton through the fistula track. This can stay in place long term but is frequently used for a few weeks only. This allows inflammation to settle, so that curative surgery can be planned

Laying open the fistula. This involves cutting out the fistula track. It is useful for those fistulae that don’t pass through the sphincter muscle or only a small part of it.

Fistula plug or fistula paste. This is a new technique. It involves inserting a plug of collagen material or injecting collagen paste into the fistula track. The advantage of this technique is that it is minimally invasive however it is not suitable for all fistulae. The advantage of this technique is that it is minimally invasive however it is not suitable for all fistulae and may be associated with higher rates of treatment failure and recurrence.

Cutting Seton. This involves using a piece of tubing or seton which is placed through the fistula and tied firmly around the sphincter muscle. This tubing is tightened up every 2-3 weeks. Using this slow tightening technique the fistula is gradually laid open.  Sometimes three or more tightenings are required.

LIFT Procedure (Ligation of Intersphincteric Fistula Tract). This is a technique that is gaining increasing popularity for treating a fistula that is involving a significant amount of the anal sphincter muscle. The technique is carried out under a general anaesthetic an involves making a small incision close to the anus. The fistula track is identified by the surgeon who then ties off both sides of the fistula before dividing it.

Updated January 2016


What are the next steps?
If you think you have this condition or any of these symptoms
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