What Is an Anal Fistula?

The anus contains numerous small glands that produce mucus. An anal fistula occurs when there is an abnormal connection between an infected anal gland and the skin surrounding the anus, allowing infected material to drain externally.

Common Signs and Symptoms

The signs and symptoms of an anal fistula may include:

• Pain and swelling around the anus
• Skin irritation
• Occasional bleeding
• Fever or chills
• Continuous drainage of purulent material (pus)
• Constipation

Causes of Anal Fistula

The primary cause of an anal fistula is the formation of anal abscesses within the anal canal. Certain conditions can significantly increase the likelihood of developing anal abscesses, leading to anal fistulas, including:

• Sexually transmitted diseases
• Crohn’s disease
• Tuberculosis
• Diverticulitis
• Anorectal cancer
• Radiation therapy

Anal Fistula Treatment

An anal fistula is a complex condition that often requires surgical intervention. The primary goal of the surgery is to eliminate the fistula while preserving the surrounding anal tissue. Dr. Mouhsen Al Hosein offers minimally invasive procedures that reduce risks, discomfort, and complications compared to traditional surgical methods.

VAAFT (Video Assisted Anal Fistula Treatment)

VAAFT is a minimally invasive, sphincter-saving technique for treating simple and complex fistulas. The surgeon uses a small scope to examine the fistula tract under direct vision, cleaning and cauterising it without requiring extensive surgical excision. If necessary, injectable collagen may be used to seal the fistula.

The VAAFT technique is performed entirely under direct endoluminal vision, allowing for the identification of secondary tracts or chronic abscesses. This approach results in minimal surgical wounds.

Other Treatment Options

• Injectable Glue/Collagen: To seal the fistula canal, biological glue or collagen is injected directly into it. This can be done as a standalone procedure or in conjunction with VAAFT.
• Seton Insertion: A drainage catheter, known as a Seton, is placed through the fistula to facilitate proper drainage of the abscess.
• Laser Procedure: The fistula is obliterated using a specialised laser that categorises the interior of the fistula.

Recovery Period

Most patients can return home within 24 hours post-procedure. Pain relievers and stool softeners may be necessary for several days at home. Typically, you can return to work within one week in most cases.

For more information or to schedule a consultation with Dr. Mouhsen Al Hosein, contact today.

FAQs

What are the different types of anal fistulas?

Anal fistulas can be classified as simple or complex, depending on their location and whether they involve the anal sphincter.

Can an anal fistula lead to complications?

Yes, untreated anal fistulas can lead to recurrent infections, abscess formation, and complications related to the anal sphincter, potentially affecting bowel control.

How is the procedure for anal fistula surgery performed?

The surgery can involve various techniques, including seton placement, VAAFT, or laser treatment, depending on the fistula’s complexity and location.

Is hospitalisation required for anal fistula surgery?

Most anal fistula surgeries are performed as day-case procedures, allowing patients to go home the same day without the need for an overnight stay.

What kind of anaesthesia is used during anal fistula surgery?

The procedure is usually performed under local anaesthesia, although some patients may opt for sedation for additional comfort.

Will I need follow-up care after surgery?

Yes, follow-up visits are essential to monitor healing and ensure the fistula has been effectively treated.

Can I resume normal activities after surgery?

While many patients can return to daily activities within a week, high-impact activities or heavy lifting may need to be avoided for a few weeks post-surgery.

What can I do to prevent anal fistulas?

Maintaining good hygiene, managing underlying conditions, and avoiding straining during bowel movements can help reduce the risk of developing anal fistulas.