Description:
A fistula-in-ano is an abnormal tunnel-like passage that forms between the anal canal or rectum and the skin around the anus. It usually occurs as a result of an anal abscess that hasn't healed properly, leading to the formation of a tract or tunnel.
Procedure:
Surgery is the primary treatment for fistula-in-ano. The surgical procedure, known as fistulotomy, involves making an incision along the length of the fistula tract to open it up and allow it to heal from the inside out. In some cases, a seton (a piece of surgical thread) may be placed in the fistula tract to keep it open and allow for drainage.
Indications/Symptoms:
Symptoms of a fistula-in-ano may include pain, swelling, redness, and discharge of pus or blood from the opening near the anus. Patients may also experience recurrent anal abscesses.
Benefits of Surgery:
Surgery for fistula-in-ano aims to remove the abnormal tract, alleviate symptoms, and prevent recurrence of abscesses. It can improve quality of life by relieving pain and discomfort associated with the condition.
Risks/Complications:
Complications of fistula surgery may include infection, bleeding, recurrence of the fistula, incontinence (rare), and delayed wound healing. It's important to follow post-operative care instructions carefully to minimize these risks.
Prevention:
Preventing anal abscesses, which can lead to fistulas, involves maintaining good anal hygiene, avoiding constipation, and treating conditions such as Crohn's disease that can increase the risk of abscess formation.
When Surgery is Needed:
Surgery is typically recommended for fistula-in-ano when conservative treatments such as antibiotics and drainage of abscesses are ineffective or when the fistula is complex or recurrent.
Before and After Surgery:
Before surgery, the doctor will perform a thorough examination and may order imaging tests to determine the extent and location of the fistula. After surgery, patients may need to follow a special diet, take medications for pain and to prevent infection, and avoid strenuous activities for a period of time.
Medications:
Medications such as pain relievers and antibiotics may be prescribed before and after surgery to manage pain and prevent infection.
It's important for patients to discuss the specifics of their condition and treatment plan with their healthcare provider to ensure they receive the most appropriate care.