Fistula

An anal fistula is a small channel that can develop at the end of the bowel and the skin near the anus. It is generally formed due to previous or current anorectal abscess. An anorectal abscess starts off due to anal gland infection. This infection then progresses to an abscess which is pus filled. An abscess further progresses to become an anal fistula when the abscess doesn’t heal completely with or without treatment.

Continuous dull or throbbing pain accentuated on sitting
Foul smelling discharge of pus and blood
Swelling, tenderness, itching or redness around the anus
Painful bowel movements
Fever
Anorectal abscess (50% of the times abscess turns into a fistula)
Crohn’s disease, Diverticulitis, etc due to inflammation of the intestines
Infections such as Tuberculosis
Sexually transmitted diseases- HIV, etc
Latrogenic – A tear during insertion of a rectal thermometer, USG probe, endoscope, enema tube
Anorectal cancer
Type 1 (Inter-Sphincteric) : Tract formed in the spaced between the two anal sphincters
Type 2 (Trans-Sphincteric) : Tract passing through both the sphincters
Type 3 (Supra-Sphincteric) : Tract loops over both internal & external sphincter through the pelvic floor muscle
Type 4 (Extra-Sphincteric) : Tract from rectum to skin without involving the sphincters
Brief history with clinical correlation and digital rectal examination
Proctoscopy to check for any associated condition in the rectum.
MRI Fistulogram in case of complicated fistulas where tract is different to comprehend

Treatment of Fistula

Fistula Surgery (Conventional Method)

Fistula surgery comes under colorectal surgery. Depending on the type of fistula, proctologists at MIRA take a call on the type (seton stitch) and number of stitches. Surgeons allow the pus to drain out and then let the wound open to heal naturally. Patients take about a week’s time to recover from the cuts and stitches. Sometimes there could be scarring too.

Laser Fistula Treatment

Laparoscopic surgeons at MIRA are pioneers of Laser Fistula Surgery in Chennai. It is a pinhole surgery through the fistula opening itself with a 360 degree laser fibre with no cuts, stitches, scars or much blood loss. It is a day care procedure and patients bounce back to their routine life very quickly.

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