Anal (or anorectal) fistulas are abnormal passages that form between the anus or rectum and the skin around the anus. They are often caused by an infection in an anal gland, which can lead to the formation of an abscess. If left untreated, the abscess can rupture and form a fistula.
Depending on the severity and complexity of the fistula, several surgical and non-invasive treatment options are available in Turkey.
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An anal abscess, a pocket of pus near the anus, is usually caused by an infection of a small anal gland. As it drains, it can give way to an anal fistula: a tunnel that connects the inside of the anus to the perianal skin.
This fistula allows chronic discharge of purulent, bloody, or fecal secretions.
The complexity of anal fistulas varies according to their anatomical course. The main distinctions are:
Treatment of anal fistulas depends on the type and severity of the fistula. The prognosis for recovery is variable and may be influenced by the presence of complications.
Anal fistulas are often the result of an inflammatory process that begins with an infection of an anal gland. This abscess, a collection of pus, may drain spontaneously or be surgically incised. In either case, a fistula may remain.
In addition to glandular infections, other factors may predispose to the development of anal fistulas:
The most common symptoms of anal fistula are:
In Turkey, anal fistula is diagnosed by a specialized doctor (proctologist). It is based on a careful clinical examination of the anal region.
The clinical examination allows to:
In some cases, additional tests may be needed:
These scans are especially useful for complex or recurrent fistulas to clarify their course and identify possible complications.
If you suspect you have an anal fistula, you should see a doctor. Early diagnosis and appropriate treatment are essential to relieve symptoms and prevent complications.
To treat anal abscesses, a surgical incision is made in the skin above the abscess to drain the infected pus. This procedure relieves pressure and promotes a quicker recovery.
This procedure can be done under local anesthesia. In some cases, hospitalization and surgery under involuntary heavy sedation may be required for a large or deep abscess.
People at higher risk of infection, such as diabetics or those with weakened immune systems, may also need to be hospitalized. The use of antibiotics is an alternative to surgical drainage of pus, but they often have limited effectiveness and may only be useful for small (2 cm) infections.
Anal fistula does not heal spontaneously and requires surgical intervention. The goal of surgery is to remove the abnormal passage to prevent recurrence and complications.
The choice of surgical technique depends on the location and complexity of the fistula. Here are the options available in Turkey:
Surgical technique | Procedure |
Fistulotomy | For simple fistulas, the surgeon incises and opens the fistula pathway, allowing the wound to heal naturally from the inside out. |
Cutting seton | For more complex fistulas, a wire is placed in the fistula path to drain the fistula and allow gradual healing. The suture can be tightened gradually or left in place for a few weeks before a second operation. |
Fistulectomy | This technique involves the complete removal of the fistula tract and the repair of the tissue. |
Modern techniques | Anal PLUG and fibrin glue injection are less invasive techniques that may be suggested for certain types of fistulas. |
Each technique has advantages and disadvantages in terms of success rate, post-operative pain, recovery time, and risk of complications. It is important to discuss these with your surgeon in Turkey to choose the most appropriate technique for your situation.
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