What is anal fistula surgery?

Anal fistula is almost always treated through surgery. Anal fistula surgery, also known as fistulectomy, involves cutting a small portion of your anal sphincter muscle to open the tract. This allows your surgeon to connect the internal opening within the canal to the external opening. A groove will be created that will heal from the inside out. Within one to two months, this will heal into a flattened scar. If the fistula involves a lot of your sphincter muscle, a two-stage procedure or more complicated surgery may be necessary.

Why anal fistula surgery?

Often, anal fistulas do not heal on their own. Treatment is generally necessary to reduce chances of infection in an anal fistula and to alleviate symptoms. Many fistulas do not respond to non-surgical therapies such as and thus require surgery and/or wound care.

Surgery has proven to be the most effective method for curing anal fistula. If proper healing occurs after the surgery, it is unlikely for anal fistula to return.

What to expect?

Before the procedure

  • Limit or cut out smoking or alcohol.
  • Stop all current medications one week prior to the procedure or as instructed by your doctor.
  • You may be given bowel preparation to help you clear your bowels before the surgery.
  • You will be asked to fast accordingly.

During the procedure

  • You will be given anaesthesia to aid in falling asleep.
  • Your surgeon will guide a probe into your fistula.
  • The probe is used as a guide to cut along the length of the fistula.
  • A tool is used to scrape out any tissue buildup from your fistula and any abscesses may also be drained.
  • Your surgeon may need to close the rectal opening to the fistula. The other opening on the skin will be held open with stitches or other alternatives. This is to allow fluid to drain and the wound to heal.
  • A bandage may be placed over your wound. Healing may take any time from one to four months on a case-by- case basis.

After the procedure

  • You may be discharged on the same day or within the next few days.
  • Discomfort will be mild to moderate for the first week post-operation. Painkillers may be administered to place this under control.
  • Laxatives may be prescribed to soften your stools to ease bowel movement.
  • Eat a diet high in fibre and consume plenty of fluids. This will also help to soften your stools.
  • Wear dressing to cushion the affected area to prevent the drainage from soiling your clothes.
  • You will need to change dressing daily.
  • You will likely be able to resume normal activities within one to two weeks.
  • Schedule a follow-up appointment with your doctor within the next two weeks.

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