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Anal Fistula

Abnormal tract between anal canal and perianal skin; surgical treatment balances cure with sphincter preservation.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Anal Fistula?

Anal fistula is a chronic epithelialized tract connecting the anal canal (internal opening) to the perianal skin (external opening), typically arising from a previous anorectal abscess.

Cryptoglandular theory (infection of anal gland in the intersphincteric plane) explains most idiopathic fistulas; Crohn's disease, trauma, malignancy, and radiation are other causes.

Parks classification divides fistulas into intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric based on relationship to the sphincter complex.

Treatment goals are elimination of the fistula, prevention of recurrence, and preservation of continence — requiring careful assessment of sphincter involvement and complexity.

Symptoms

Presentations requiring surgery:
Recurrent perianal drainage (pus, blood, or mucus)
Perianal pain, pruritus, and skin irritation
Palpable external opening with induration
Prior perianal abscess with persistent or recurrent drainage
Soiling and perianal skin maceration

Risk Factors

Fecal incontinence after fistula surgery (especially with sphincter division)
Crohn's disease (recurrent and complex fistulas)
HIV or immunocompromise (altered healing, atypical organisms)
Prior perianal surgery or obstetric trauma (weakened sphincter)
Complex fistula with multiple tracts or horseshoe extension
Female sex with anterior fistula (thin anterior sphincter)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent perianal drainage, pain, or swelling
  • Known prior anorectal abscess with persistent symptoms
  • Crohn's disease with new perianal symptoms

Treatment Methods

01
Fistulotomy for simple low fistulas with minimal sphincter involvement
02
Loose seton placement for drainage in complex or high fistulas
03
LIFT (ligation of intersphincteric fistula tract) for transsphincteric fistulas
04
Endorectal advancement flap for high complex fistulas
05
Biologic plug, fibrin glue, or FiLaC (laser) as sphincter-sparing options
06
Medical therapy with anti-TNF agents for Crohn's-related fistulas combined with surgery

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.