Anal fistula surgery treats a small tunnel between the skin near the anus and the end of the bowel. This condition causes discomfort, pain, and drainage of pus or feces.
Surgery removes the fistula tract to promote healing and prevent recurrence. This article explores the causes, surgical techniques, recovery, and complications of anal fistulas. Understanding this surgery is crucial for those considering treatment or managing this condition.
What Is An Anal Fistula?
An anal fistula is a small tube that connects an infected cavity in the rectum to the anus. Your anus is the opening where you expel feces from the body.
Inside this hole lie multiple small glands that expel mucus. When glands become blocked, they can cause infection and lead to an abscess, which may develop into a fistula.
What Are The Causes And Anal Fistula?
The most common cause is blocked anal glands, which lead to abscesses.
However, there are other causes which include:
- Trauma
- Tuberculosis
- Cancer
- Crohn’s Disease
- Radiation
- Sexually transmitted diseases
- Diverticulitis
The Symptoms Of An Anal Fistula
If you experience any of these terrible symptoms, you may have an anal fistula:
- Fever, chills, and fatigue
- Frequent anal abscesses
- Bleeding
- Pain and swelling around the anus
- Pain when excreting feces
Bloody and nasty-smelling pus is coming from the opening of the rectum.
- Pain may subside once the fistula drains.
- The drainage causes irritable skin around the anus.
How is an anal fistula diagnosed?
Your doctor usually finds an anal fistula during a physical exam. They will check around your anus and lower rectum for lumps or masses.
Additional tests may be necessary to confirm it, such as:
- Anoscopy: Your doctor checks the skin around and inside your anus for issues like fissures or abscesses.
- Rectal exam: Your doctor examines your rectum for lumps or masses using a lubricated finger.
- During a sigmoidoscopy, the doctor inserts a thin tube into your rectum to examine tissue samples inside your bowel.
types of anal fistulae
There are several different types of surgery for anal fistulas:
Anal Fistula Treatment:
Surgery: A surgeon makes a small cut on the skin near the anus to remove scar tissue causing the problem. They may also address enlarged veins. After surgery, patients use topical creams for healing.
Perineal Fistulotomy:
Procedure: Surgeons cut the anus to remove scar tissue and check for enlarged blood vessels. This may require follow-up visits under anesthesia if complications arise.
Fistulectomy:
During this surgery, the doctor removes tissue from the anal canal to treat the fistula. This may include removing mucosa and muscle tissue if necessary.
Preventing Constipation:
- Dietary Changes: To prevent irregular bowel movements, eat more fruits and vegetables, drink plenty of water, and reduce stress.
- Consultation: Talk to your surgeon about Lactulose, ensuring you have a valid prescription.
- If Lactulose isn’t suitable, discuss other options, such as laxatives, with your physician to find the right fit.
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fistula surgery for dialysis
Fistula surgery for dialysis creates a direct link between an artery and vein to improve blood filtration during dialysis. Unlike catheters or grafts, AV fistulas are more durable and have lower clotting risks.
- The Procedure:
The surgeon makes a small incision in the arm to connect an artery to a vein and then closes it with sutures during surgery. Over several weeks, the fistula develops until it’s ready for dialysis.
- Dialysis Process:
Once the fistula matures, patients can go to a dialysis center for treatment. The doctor inserts two needles into the fistula, one to remove blood and the other to return filtered blood to the body.
- Benefits:
- Longer lifespan compared to other access methods.
- Reduced risk of clotting and infection.
- Better blood flow for efficient dialysis.
- While generally safe, surgery carries standard risks like bleeding and infection.
fistula surgery recovery
Most surgeries are effective. Afterward, take warm baths called sitz baths to feel better, but don’t overdo it as it can cause discomfort.
Use stool softeners or laxatives for a few days to avoid irritating the area. Be gentle when wiping to prevent further irritation. You may feel discomfort or pain after the procedure. Your doctor will likely give you a numbing injection to help. Pain medication can also help relieve discomfort.
If surgery and recovery go well, the anal fistula is unlikely to return. For women, use thin sanitary towels for extra padding, placing them at the back of your underwear.
Other things to remember:
- Avoid excessive walking or running.
- Don’t lift heavy objects (over 5kg) for at least two weeks, such as children or heavy bags.
Sexual Activity:
- Avoid sexual activity for at least two weeks to prevent damage or dislodging the seton.
- After two weeks, if you feel ready for intercourse, proceed with caution to avoid moving the seton.
Constipation:
- Prevent constipation to avoid straining during bowel movements, which could disrupt the seton and cause complications.
- Increase fiber intake with fruits and vegetables and drink plenty of water for regular bowel movements.
- Consider Lactulose for loosening stools, but discuss with your surgeon for a prescription.
- If lactose isn’t an option, consult your doctor about alternative laxatives or stool softeners suitable for you.
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Anal fistula surgery cost
Anal fistula surgery costs vary depending on factors like procedure complexity, surgeon fees, and location, including insurance coverage.
Here’s an overview:
- UK: Usually £5,000 to £10,000.
- USA: Typically $5,000 to $10,000.
- Turkey: Generally $2,000 to $5,000.
Turkey offers lower costs because of reduced living and medical expenses. Turkish hospitals and surgeons specialize in this procedure and may discuss prices directly with patients. Individual cases may vary.
fistula laser surgery
Fistula laser surgery is a minimally invasive procedure that uses laser technology to treat fistulas. The laser targets the fistula tract, vaporizing the tissue to seal it. This promotes healing and closure of the fistula.
The process is usually done with local anesthesia, causing less pain, faster healing, and minimal scarring than traditional surgery.
fistula laser treatment cost
Fistula laser treatment typically costs between 1500 and 4000 euros. The cost of the procedure depends on several factors. These factors comprise the complexity of the procedure, the location of the treatment center, and the services provided. To get an accurate estimate, consult a healthcare provider or medical facility based on your needs.
What Are The Risks Associated With Anal Fistula?
There are some risks associated with anal fistula surgery, which include:
- Severe pain that over-the-counter pain medication might not be able to treat.
- Continuous bleeding
- The seton dislodging
- Infection
When You Should Call Your Healthcare Provider
If you notice any of these signs after your procedure, go to the doctor right away. This is especially important if you have had anal abscess problems before.
- Fever of 100.4°F or higher
- Return of anal fistula symptoms like pain or drainage
- Severe pain, swelling, or drainage around the anus or rectum
- Difficulty controlling bowel movements
- Hard or painful stools
- Presence of mucus, pus, or blood in stool, which may appear dark or bright red
- Stomach pain that persists despite medication for more than a few hours
- Continuous nausea or vomiting
fistula surgery success rate
Success rates for fistula surgery vary based on its purpose. For dialysis fistulas, success rates range from 70% to 90%, depending on the procedure used. Anal fistula procedures typically have success rates between 60% and 90%, depending on the approach.
Since outcomes can differ widely, it’s important to discuss your expectations with your healthcare provider before undergoing any surgery.
Final Thoughts
An anal fistula is a small tube connecting a rectal abscess to the anus. Causes include blocked glands, trauma, disease, or infection. Diagnosis involves a physical exam or imaging tests like ultrasound or MRI.
Treatment options include surgery or other procedures like placing a seton or fistulotomy. During recovery, take sitz baths, add fiber to your diet, and avoid excessive wiping. Risks include pain, bleeding, and infection. Seek medical help if you experience fever, pain, bowel issues, bleeding, or vomiting after surgery.
anal fistula surgery FAQs
How do you heal a fistula without surgery?
Healing a fistula without surgery can be challenging and often requires medical management, antibiotics, and lifestyle modifications in order to control symptoms; however, full healing without surgical intervention remains rare.
How long does fistula surgery take?
Fistula surgery typically lasts several hours. The exact duration will depend on its complexity and type.
Can a fistula come back after surgery?
Yes, fistulas may return after surgery; however, the chances of this occurring depend on various factors like the type of procedure performed and the health status of the individual patient.
Is fistula surgery painful?
Surgery to correct fistulae is typically conducted under general anesthesia, so you won’t experience any discomfort during or after the process. After surgery, there may be some discomfort after recovery, which can be managed with prescribed medications.
Is fistula surgery dangerous?
Fistula surgery carries some risks, including infection, bleeding, or structural damage to nearby structures; however, when performed by an experienced surgeon in a properly equipped facility it’s generally considered safe.
How is fistula surgery done?
Fistula surgery entails creating an alternative path for fluids to drain properly, using procedures such as fistulotomy, fistulectomy, seton placement, or advancement flap repair in order to block off an abnormal tract and close it off.
