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Anal fistula surgery

The purpose of the anal fistula surgery is to eliminate the fistula near the anus. The nature of surgical intervention depends on the location of the fistula. If it runs smoothly under the skin and does not affect the constrictor, then a relatively simple surgical procedure is performed to open the skin through local anesthesia and clean the inside of the fistula. After that, we leave it open and let it heal similar to a wound.

However, if the fistula is located higher in the rectum and passes through the rectum constrictor, it requires more complicated surgical intervention. It is very important that during surgery, the rectal constrictor should not be damaged.

What is anal fistula?

Fistula is referred to as abnormal lesions when there is a connection between organs or body cavities in the body (internal fistula) through which the liquid, the solid material pass unnatural, or there is an abnormal connection with the outside world. These pathological connections may be congenital, resulting of an accident, infection, or surgical intervention.

How does the last part of the colon, the rectum look like?

Anatomy of the colon
Anatomy of the colon

The colon is located in the abdominal cavity, bordering frame-like the small intestine. It can be divided into several phases: the input part is the cervix, followed by the ascending branch followed by the transverse colon, the descending branch and the sigmoid. The rectum on the last part of the colon is located in the pelvis.

The external orifice of the rectum is the anus. It is operated by two constrictors, the inner, non-voluntary, and the outer voluntary constrictor. They provide voluntary bowel movements (continentia) and defecation.

The proctologist is the specialist in disorders and diseases at this stage.

What causes anal fistula?

The anal fistula may be a result of some previous inflammation or abscess but may result from foreign body, perforation or Crohn’s disease. It can be developed because of the inflamed glands between the muscle layers of the intestinal wall, too. As a consequence of inflammation, the sanies accumulating in the rectum is trying to escape the tissues around the rectum, and in the meantime, it generates pathways for itself. When it surfaced, it usually occurs as abscess, which is a painful nodule in the anus. The abscess usually involves fever and requires immediate surgical intervention.

What are the symptoms of anal fistula?

The most common pain is the purulent, bloody discharge and the temporary tension pain, which occurs continuously or for shorter and longer period.

The consistency and quality of the stool are often associated with the intensity of the complaints.

In the event of their sustained existence, they maintain chronic inflammation, sometimes causing abscesses.

This can even damage the function of the rectum muscle.

Anal disorders
Anal disorders

How do we diagnose anal fistula?

The first and most important part of the diagnosis is the physical examination, finding the external opening of the fistula. During the examination, it is possible to determine the path of the fistula and its location. If it is located higher and cannot be reached by fingers from the rectum its location can be easily determined by contrast material imaging process or by X-ray in order to define treatment procedure. If there is a suspicion of co-disease colonoscopy may be necessary.

Treatment methods of anal fistula

The solution of chronic, several months of existing fistulas is expected from surgical interventions (anal fistula surgery). The lower, superficial fistulas can be surgically treated by local anesthesia and surgical outpatient care.

Higher lesions require a stay in our private hospital since surgery requires a major surgical intervention because of the constrictors and is performed in anesthesia or local anesthesia near the spine. These surgeries will take 1-3 days to stay, depending on the method of anesthesia and the type of surgery performed.

During the surgery absorbable suture are inserted. In the first few days, it is important to have a looser, easier to defecate stool than usual. Therefore, it is necessary to consume plenty of liquid and less solid food. It is also advisable to avoid constipation by consuming liquid, multiple plant fibers, and probiotic cure. To relieve the initial pain, non-steroidal painkiller can be taken.

How should I prepare for the surgery?

It is important you are aware of the limitations your doctor may require, for example, that no solid food can be eaten on the day before the surgery. Make a list of all the medicines, vitamins and nutritional supplements you have taken.

Please let us know about the most important medical information, including other illnesses and important personal information, such as recent changes in your life or stress.

All our patients are asked to complete a detailed medical history, which is necessary for our surgeon and doctors to decide if you are a good candidate for the surgery.

What shall I do after anal polyp removal?

Since the fistulas are very diverse, so its nature and recovery period. The ones on the surface can be healed well, but the recovery time may take months. The ones located higher, branching and uncared are more difficult to treat. In their case, the treatment is done by combined operations. For this reason, it is important when you notice the symptoms, contact your doctor as soon as possible.