An anal fistula is a small tunnel with an internal opening in the anal canal and an external opening in the skin near the anus. It most often develops after an anal abscess that has not healed properly, so anyone who has had an abscess is at higher risk. Surgery relieves symptoms and reduces the chance of further infection.
Why every case is assessed individually
A fistula sits close to the anal sphincter muscles, which control bowel emptying. Treatment has to be planned carefully so those muscles are affected as little as possible. The right approach depends on where the fistula is, how complex the tract is, and the condition of your sphincter muscles.
What the operation involves
Professor El-Khoury first locates the internal opening of the fistula. What follows depends on the findings, particularly how much sphincter muscle is involved in the tract.
With a more complex fistula, such as a horseshoe fistula where the tract wraps around both sides with external openings on either side of the anus, the approach is to open the section where the tracts join and clear the remaining tracts.
Where a large amount of muscle would have to be divided, treatment is staged across more than one operation. If the tract cannot be traced completely, further surgery may be needed.
Professor El-Khoury will talk through the operation with you in the rooms, covering why it is being recommended, what it involves, the risks and the benefits. He also provides Royal Australasian College of Surgeons information sheets on the procedure so you can read them at home and bring questions back.
This page is general information, not medical advice. What applies to you depends on your history, your examination and your results. Bring your questions to the consultation.