What is an anal fistula?
A fistula is an abnormal connection between two organs or two tissue surfaces. An anal fistula (fistula-in-ano) is a connection between the anal canal and the skin.
Causes and Symptoms
More than 90% anal fistulae are a result of an anorectal abscess. An anorectal abscess begins with infection in one of the anal glands. The infection may stay in the space between the sphincters (the intersphincteric space), may spread down to the perianal skin, or may extend through the external anal sphincter.
With a previous history of perianal abscess or any surgical intervention in past, patients having fistula in ano presents with complaints of persistent discharge of pus through an external opening in perianal skin. The other characteristic part of patients complaints include sudden appearance of pain and swelling in the previously dormant perianal region, followed by discharge of pus and relief of pain. Associated fever can also be a feature.
WHAT IS THE CHALLENGE IN TREATING ANAL FISTULAS?
The biggest challenge is to prevent recurrence. Recurrence of fistula inspite of best surgical treatment can happen for following reasons.
1. High fistula/ complicated fistulas do have higher recurrence rates than low or simple fistula
2. Previously operated for multiple times can have higher recurrence rates
3. Presence of co-morbid diseases like Tuberculosis, Diabetes, Chronic Disease, Malignancy
4. Wrong diagnosis of the type and different variants of complex fistula
5. In experienced surgeon.
PELVINIC’S APPROACH TOWARDS YOUR FISTULA PROBLEM
The goals of treatment of a fistula-in-ano are the elimination of sepsis and of the fistula tract, the prevention of recurrence, and the preservation of continence. At PELVINIC we boast of Dr Sandip Banerjee who not only understand this problem much better than others but also has delivered success in treating various bad and complicated fistulas. The various procedures performed by him in case of anal fistulas are Fistulotomy, Fistulectomy, Seton Placement, SLOFT (Submucosal ligation of fistulous tract), LIFT (Ligation of Intersphincteric Fistulous Tract), Laser, Radiofrequency Ablation and VAAFT. Some of the procedures listed above are rarely performed by surgeons in North India. Once developed, fistula can be a nightmare specially in achieving complete treatment. What is advisable is to see an expert Coloproctologist so that your further worries are limited.