Overview
A fistula-in-ano is an abnormal tunnel or tract that forms between the inner lining of the anal canal and the skin surrounding the anus. It typically develops as a complication of a perianal abscess when an abscess fails to heal completely, a persistent communication develops between the abscess cavity and the skin surface. The condition presents with chronic discharge, pain, swelling, and recurrent infection around the anal region. Fistula-in-ano does not resolve spontaneously and requires surgical treatment to eliminate the tract, manage infection, and restore normal anorectal function while preserving continence.
The Procedure
At ILS Hospitals, the surgical approach for fistula-in-ano is carefully chosen based on the type and complexity of the fistula, particularly its relationship to the anal sphincter muscles. Common procedures include fistulotomy (laying open the tract), fistulectomy (complete excision of the tract), and seton placement, a staged technique used for high or complex fistulae that pass through a significant portion of the sphincter, to protect continence. Advanced techniques such as video-assisted anal fistula treatment (VAAFT) and ligation of the intersphincteric fistula tract (LIFT) may also be employed for complex cases. Surgery is performed under spinal or general anaesthesia.
Recovery
Recovery following fistula surgery depends on the complexity of the procedure. Simple fistulotomies heal within 4 to 6 weeks with regular wound care, sitz baths, and dressing changes. Complex cases may require longer healing periods and multiple staged procedures. Dietary management to ensure soft stools is an important component of post-operative care. At ILS Hospitals, our colorectal surgeons are highly experienced in managing the full spectrum of anorectal conditions, providing surgical solutions that are both effective and designed to protect the patient’s quality of life and long-term continence.
