A fistula in ano is an abnormal tract running from the anus to the skin, that usually develops after an infection in one of the anal glands. Treatment of a fistula depends on the anatomy of the tract – specifically how much of the anal sphincter is involved in the tract. If only a small amount of the sphincter seems to be involved, and treatment is unlikely to effect continence, then a simple “fistulotomy” can be performed. This involves placing a probe through the fistula then incising on to this probe, allowing the tract to be “laid open”. More complex fistulae may need more complex and sometimes multiple procedures involving drains, Setons, plugs, flaps, lifts and rarely, stomas. Before embarking on a of course of treatment, complex fistulae need to be thoroughly discussed with your surgeon.
Dressing and otherwise caring for you fistula wound is usually quite straightforward. You will be given specific instructions on the day of surgery, but they usually include regular warm salt or sitz baths, avoiding hard wiping of the area, the use of perianal pads, and taking of stool softeners, pain medicine, fibre supplements and possibly a laxative.