Fistula Surgery: Treatment, Procedure, Cost, Recovery, Side Effects And More (2022)

What is the treatment?

A fistula occurs when an abscess(pus) causes a tract to develop between the lining on the interior of the anal canal and the skin around the anus. Fistulas can also occur due to Crohn's disease, sexually transmitted diseases, ulcerative colitis, tuberculosis, irritable bowel syndrome etc.

Very few fistulas heal on their own and need surgery. But the type of surgery required depends on the type and position of the fistula. A simple fistula can comprise of a single tract while more complicated ones can have numerous branches reaching into the anal sphincter muscles. The most prevalent type of fistula surgery is a Fistulotomy which is suitable for a simple fistula that is positioned below the sphincter muscles. For the other complicated fistulas, there are other techniques such as inserting stitches or plugs and others.

(Video) Anal Fistula Recovery Time | Dr. Kiran Shah by Apollo Spectra Hospitals

Like every surgery, fistula surgeries too carry a certain amount of risk. The percentage of risk, however, varies depending on the position and complexity of the fistula and the type of surgery required for it. Surgeons recommend the type of surgery keeping the risk factor in mind too.

What is Fistula Surgery?

Fistula Surgery, also known by the name of fistuotomy can be described as a medical procedure specially designed to treat fistula present in the anal.

The primary goal of this treatment is to remove build-up fluids like puss out of small openings developed between anal skin and the end of the anus. The surgical procedure will aid the patient to close up and heal the wounds of the anus fast caused by previous injury, infection, or inflammation.

One thing I need to remember is that it should not be left untreated even after surgery, take your prescription as per the doctor's instructions carefully and on time. As it can lead to serious medical complications like cancer or sepsis.

Yes, as they make an incision to remove all the fluid buildup, it can be painful for the patient without any numbing agent. Your medical professionals will use local or general anesthetic to reduce the pain.

The patient also experienced some pain post-surgery as well. For the initial first week of the surgery, the pain can be very discomforting, to reduce the pain your doctor may prescribe you a combination of painkillers and antibiotics.

(Video) Fistula Repair Operation

The success rate of Fistula Surgery depends on the healing and post-surgery care of the wounds. The main objective of the fistula is to remove all the infected fluid, but the treatment post-surgery includes the recovery of wounds and elimination of any traces that may have been left in the wounds during surgery. As per reports, the success rate of Fistula Surgery is approximately 87-94 percent.

Yes, if not taken care of, the anal fistula can come back within one year of the surgery. It can also come back after 3-5 years too, all you need to make sure that your anal is taken care of nicely. As per the data, the probability of anal fissure to come back is approximately 7-50 percent amongst its patients.

How is the treatment done?

Fistula surgery is generally performed while the patient is under general anaesthetic.

(Video) Common fears after fistula treatment - Dr. Parameshwara C M

In a fistulotomy, the most common type of fistula surgery, the surgeon cuts open the fistula along its length to scrub out its contents. The wound is then left open for it to heal into a flat scar. A fistulotomy is very effective for fistula treatment, provided the fistula does not pass through the shphincter muscles. If a surgeon has to cut even a very small portion of the sphincter muscle during the surgery, it is done with great care to avoid any risk of bowel incontinence.

If the fistula comprises of several tracts that have branched into a considerable portion of the sphincter muscles, surgeons often recommnend the seton technique. In this technique, a surgical thread is left inside the fistula for few months to drain out the pus. This helps the fistula to heal while keeping the sphincter muscles intact. In the case of these fistulas, surgeons may also recommend performing several fistulotomies over a course of time by opening up a small portion of the fistula each time.

There is also the advancement flap procedure in which the fistula is flushed out and its internal opening is then covered with a tissue taken from the inside of the patient's rectum. In another procedure, surgeons use a cone-shaped plug made from pig-bowel to cover the internal opening of the fistula. All these procedures are performed when fistulotomies seem to carry a high risk of incontinence.

Who is eligible for the treatment? (When is the treatment done?)

The common symptoms of a fistula are a thumping, constant pain and irritation around the anus, fever, diarrhoea, bloody stools etc. If someone's suffering from these symptoms and the doctor is able to confirm the presence of a fistula, then that person is eligible for a fistula surgery as most fistulas require surgeries for complete healing.

Who is not eligible for the treatment?

Information not available

Are there any side effects?

Like most surgeries, fistula surgery too carries a risk of infection which can be treated with just a course of anti-biotics. Bowel incontinence is another risk of this surgery although a case of severe incontinence is very infrequent. Pain and bleeding can also happen which may require the patient to wear pads for a few weeks after the surgery.

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What are the post-treatment guidelines?

After a fistula surgery, the patient has to be at complete rest for a few days with as little walking as possible for the wound to heal properly and completely. The patient can't exercise for a few weeks after surgery and needs the doctor's permission to start the same. If there's bleeding from the wound, the patient has to wear pads.

Bowel movement post-Fistula Surgery can be difficult for the patient. One may also feel constipation for 1 or 2 days after the surgery. Here are some of the things that one needs to take care of to reduce the pain and avoid constipation or any other medical problem.

  • Apply prescribed ointments and creams on the lining of your anus to keep it moisturize and seep up the recovery.
  • Avoid toilet paper to wipe your anal area, it will only increase the friction. Use wet wipes or wet cotton to keep it clean.
  • Take a warm bath to clean or soothe the sore muscles.
  • If your stool is too hard, you can use psyllium or Benefiber products like Metamucil, Citrucel, or Konsyl along with stool softener like Colace or surfak to ease up your bowel movement.
  • You can also use lubricant or Vaseline to pass your stool without any discomfort.
  • Drink citrate or milk of magnesium to soften the stool.
  • If you were not able to pass your bowels for almost four days in a row post-surgery, consult your doctor immediately.

How long does it take to recover?

Depending on the complexity of the fistula and the type of surgery performed, it can take a patient a few weeks' time to several months to heal completely. In a very small number of cases, the fistula may come back though.

What is the price of the treatment in India?

The price of the treatment in India depends on a lot of factors. While you can get it done for practically free at any government hospital, getting the surgery done anywhere else will cost you anything from Rs.5,000 to Rs. 50,000 depending on the type and number of procedures required.

Are the results of the treatment permanent?

A fistulotomy is a very effective solution to fistulas and is usually able to heal them completely. The fistulas, however, may recur in a very small number of cases.

(Video) Closure of Fistula Tract with Laser - #shorts

What are the alternatives to the treatment?

The use of fibrin glue is the only available non-surgical solution for treating fistulas. The procedure involves injecting fibrin glue into the fistula to seal it off. While this may not be a very effective long-term solution, this can help avoid cutting into the anal sphincter muscles.

Summary: Fistula Surgery, also known by the name of fistulotomy can be described as a medical procedure specially designed to treat fistula present in the anal. The recovery rate of the procedure is quite high if the patient follows the prescription as per the doctor's instructions.

FAQs

How long is recovery after fistula? ›

Most people can go back to work and their normal routine 1 to 2 weeks after surgery. It will probably take several weeks to several months for your fistula to completely heal. This depends on the size of your fistula and how much surgery you had.

What is the success rate of fistula surgery? ›

Fistulotomy remains one of the most commonly performed operations for anal fistula with a reported success rate ranging from 87% to 94%.

Is operation Good for fistula? ›

Surgery is usually necessary to treat an anal fistula as they usually do not heal by themselves. There are several different procedures. The best option for you will depend on the position of your fistula and whether it's a single channel or branches off in different directions.

Can I walk after fistula surgery? ›

You may need rest for a few days after your operation, but you should avoid sitting still for a long time. Also avoid doing too much walking.

Is fistula 100 curable? ›

Anal fistula a challenge for modern surgery but curable by grade kshar-sutra in Ayurveda (Indian system of medicine).

Can fistula surgery go wrong? ›

Fistula Repair Complications

As with any procedure, it's possible for complications to happen, although this is uncommon. Possible complications associated with fistula repair procedures include: Bowel blockage (obstruction) Infection.

What is the risk of fistula? ›

The formation of an perianal fistula typically occurs as a consequence of an anorectal abscess. However, other risk factors for their formation include: Inflammatory bowel disease, mainly perianal Crohn's Disease. Systemic diseases, typically Diabetes Mellitus.

Is fistula a serious problem? ›

How serious is a fistula? Fistulas can cause a lot of discomfort, and if left untreated, may cause serious complications. Some fistulas can cause a bacteria infection, which may result in sepsis, a dangerous condition that can lead to low blood pressure, organ damage or even death.

Which fistula is best? ›

Use of the arteriovenous (AV) fistula for dialysis is considered by far to be the best option. In comparison to other types of access, the AVF dialysis has lower complication rates, is less prone to infection or blood clotting and allows for a greater blood flow.

How long is surgery for fistula? ›

The operation usually takes 15 to 30 minutes. To lessen the risk of bowel incontinence (when you pass a bowel movement without wanting to) your treatment may involve several operations over a number of months. The type of surgery you need will depend on where the fistula is.

How long is hospital stay for fistula surgery? ›

With a fistulotomy, a person will usually go home the same day. They may have some pain and drainage from the wound but should be able to return to work within a day or two.

Do all fistulas need surgery? ›

Fistulas require immediate medical attention to prevent serious infections or other problems from developing. Treatment options include medications, surgery, or both. Fistulas form when inflammation causes sores, or ulcers, to form on the inside wall of the intestine or nearby organs.

How painful is fistula surgery? ›

Following your fistulotomy, you may experience some mild to moderate pain or discomfort in your rectal area. You may also experience constipation, difficulty urinating, and possibly some rectal bleeding. The following are some general guidelines for proper care after your procedure.

Is laser treatment good for fistula? ›

Conclusions: Laser closure is a safe and effective treatment for transphinteric anal fistula. The fistula length is the only significant prognostic factor when closing anal fistulas exclusively with laser: shorter fistulas have a better outcome.

What should I wear after fistula surgery? ›

There may be some bleeding or discharge from the wound, especially when patients go to the toilet, particularly in the first couple of weeks after surgery. Some patients find that it is helpful to wear a sanitary towel or a soft gauze pad inside their underwear to avoid staining of clothes during this time.

Can a fistula reopen after surgery? ›

They are usually associated with high risk of re-recurrence and fecal incontinence. The risk factors for recurrence of anal fistula after surgery include preoperative, intraoperative, and postoperative factors. Thorough assessment of recurrent anal fistulas is crucial before planning treatment.

Can fistula be cured permanently? ›

After that, the patient has several options for surgical removal of fistula including Fistulotomy, Advancement Rectal Flap, LIFT, Seton Placement, Muscle flap, Laser surgery, etc. Among them, laser treatment is the safest, easiest and quickest cure for fistula. The laser treatment is the permanent cure for fistula.

Is fistula temporary or permanent? ›

A fistula will usually last for many years. A fistula usually takes one to four months to “mature” or enlarge before it can be used. If you are already receiving hemodialysis using an AV graft or catheter, ask your doctor about the benefits of a fistula. An AV (artery- vein) graft is the second choice for an access.

How many times can a fistula come back? ›

Recurrence of the Fistula

For some patients, the fistula will recur after the surgery. It is estimated that the recurrence rate is approximately 7-21%, primarily depending on the type of fistula, and the surgical procedure that was used to remove the fistula. Fibrin glue, for example, has a high recurrence rate.

What is a grade 3 fistula? ›

Traversement of the external sphincter denotes a grade 3 fistula, which is also known as a trans-sphincteric fistula. A trans-sphincteric fistula with an abscess or an additional tract in the ischiorectal fossa is classified as a grade IV.

Can fistulas come back? ›

Unfortunately, despite proper treatment and complete healing, an abscess or a fistula can come back. If an abscess comes back, it suggests that perhaps there is a fistula that needs to be treated. If a fistula comes back, additional surgery will likely be required to treat the problem.

Is fistula surgery simple? ›

The most common type of operation for simple fistulas is a fistulotomy. This involves opening up the fistula so that it can heal from the inside out. Once your anaesthetic has taken effect, your surgeon will put a probe (a thin metal instrument) into the opening of the fistula to help them find the fistula.

Who is at risk of fistula? ›

Seven primary risk factors for obstetrical fistula commonly reported include the place of birth and presence of a skilled birth attendant, the duration of labor and the use of a partograph, the lack of prenatal care, early marriage and young age at delivery, older age, lack of family planning, and a number of other ...

Is a fistula cancerous? ›

A fistula is an opening between areas of the body that are not usually connected. Sometimes this can be caused by cancer treatment. Less commonly, a fistula can be caused by cancer growing into an area of the body. Fistulas caused by cancer are rare and can take many months or years to develop.

What happens when fistula fails? ›

If your access is not working well, it can decrease the amount of fluid and toxin removal your dialysis treatment achieves. This, in turn, can affect your overall health and how you feel. If you suspect there's a problem with your fistula, notify your dialysis care team right away.

Can you live with fistula? ›

Although fistulas are associated with IBD, they can occur several years before the condition is diagnosed. While rarely life-threatening, fistulas can decrease people's quality of life and often need combined medical and surgical treatment.

Are fistulas normal? ›

Fistulas can occur in various parts of the body. In women, fistulas involving the genital and urinary tracts are the most common and happen due to prolonged or obstructed childbirth, injury during pelvic surgery, infection, inflammation, or radiation treatment in the pelvis or genital area.

Which food is good for fistula patient? ›

Patients suffering from fistula should drink plenty of water and add food items rich in fibre to their daily diet. Make some changes in their food habit and in addition, they can inculcate the following: Cereals: Cereals include a wide array of food items like broken wheat, quinoa, brown rice, ragi and oatmeal.

Which scan is best for fistula? ›

Magnetic resonance imaging (MRI) is the best imaging modality for preoperative assessment of patients with anal fistula. MRI helps to accurately demonstrate disease extension and predict prognosis. This in turn helps make therapy decisions and monitor therapy.

How long does pain last after fistula surgery? ›

This surgery opens and drains an anal fistula and helps it heal. You may be worried about having a bowel movement after your surgery. You will likely have some pain and bleeding with bowel movements for the first 1 to 2 weeks.

Where is fistula located? ›

A fistula is an abnormal connection between an organ, vessel, or intestine and another organ, vessel or intestine, or the skin. Fistulas can be thought of as tubes connecting internal tubular structures, such as arteries, veins, or intestine, to one another or to the skin.

What is the length of fistula? ›

External fistula tracts averaged about 3 cm in length but could be as long as 7 cm or more.

Is Ayurvedic treatment good for fistula? ›

For a lot of patients, the condition cannot be treated using medicines. The only way a doctor can ensure healing is by excising the entire part (fistula). But Ayurvedic treatments are quite capable! Ayurvedic treatments are performed with herbs and help maintain an excellent digestive system.

Can you live with a fistula without surgery? ›

Fistula tracts must be treated because they will not heal on their own. There is a risk of developing cancer in the fistula tract if left untreated for a long period of time. Most fistulas are simple to treat. Either the tract or fistula can be opened or the tract and the pocket inside are completely removed.

What are the restrictions after fistula surgery? ›

Keep your wound covered for seven days. Avoid any heavy lifting/ pressure with your fistula arm for two weeks. Do not keep your fistula arm bent for long periods.

How much pain will I be in after fistula surgery? ›

Following your fistulotomy, you may experience some mild to moderate pain or discomfort in your rectal area. You may also experience constipation, difficulty urinating, and possibly some rectal bleeding.

How long is hospital stay for fistula surgery? ›

With a fistulotomy, a person will usually go home the same day. They may have some pain and drainage from the wound but should be able to return to work within a day or two.

Is fistula surgery scary? ›

Women with Crohn's disease can also develop a fistula between the rectum and vagina, which may be difficult to treat. Surgical treatment depends on individual circumstances. Fistulas sound scary, but they are treatable.

Which fruit is good after fistula surgery? ›

Vegetables: All gourds-bitter gourd, snake gourd, ridge gourd, Cauliflower, Spinach, Carrot, bottle gourd, ivy gourd, ladies finger, green leafy vegetables. Fruits: Custard Apple, Pears, Grape and Watermelon, Oranges, Papaya, Banana, and Apple.

Which exercise is best for fistula? ›

To perform fistula exercises:
  • Get a tennis ball, nerf-ball, or other soft ball you can hold comfortably in your hand.
  • Place the ball in the hand on the same side as your fistula.
  • Squeeze the ball 10 to 15 times a minute for 1-2 minutes.
  • Repeat this exercise 10 to 20 times each day.

What should I wear after fistula surgery? ›

There may be some bleeding or discharge from the wound, especially when patients go to the toilet, particularly in the first couple of weeks after surgery. Some patients find that it is helpful to wear a sanitary towel or a soft gauze pad inside their underwear to avoid staining of clothes during this time.

Can I take a bath after fistula surgery? ›

Most people are able to return to work within 1 to 2 weeks after surgery. Shower or take baths as usual.

Which is the best medicine for fistula? ›

Drugs used to treat Anal Fissure and Fistula
Drug nameRatingRx/OTC
Expand current row for information about Rectiv Rectiv6.8Rx
Generic name: nitroglycerin systemic Drug class: antianginal agents, vasodilators For consumers: dosage, interactions, side effects For professionals: Prescribing Information
4 more rows

Can fistula surgery go wrong? ›

Fistula Repair Complications

As with any procedure, it's possible for complications to happen, although this is uncommon. Possible complications associated with fistula repair procedures include: Bowel blockage (obstruction) Infection.

How much time does fistula surgery take? ›

The operation usually takes 15 to 30 minutes. To lessen the risk of bowel incontinence (when you pass a bowel movement without wanting to) your treatment may involve several operations over a number of months. The type of surgery you need will depend on where the fistula is.

How serious is a fistula? ›

How serious is a fistula? Fistulas can cause a lot of discomfort, and if left untreated, may cause serious complications. Some fistulas can cause a bacteria infection, which may result in sepsis, a dangerous condition that can lead to low blood pressure, organ damage or even death.

What is the disadvantage of a fistula? ›

The main disadvantages of having an AV fistula can be: If you need dialysis right away, you will need a temporary access that can be used while your AV fistula is healing and maturing. Healing can sometimes take longer than expected, or the access may fail to mature.

Is fistula surgery painful? ›

Is fistula surgery painful? You're likely to have some discomfort for a week or so after anal fistula surgery. You can take over-the-counter painkillers such as paracetamol or ibuprofen if you need pain relief.

Videos

1. Success rate, precautions, recurrence after fistula surgery recovery care after surgery
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2. What is VAAFT? | Dr. Chris's Take
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3. What will happen if a fistula is left untreated? - Dr. Rajasekhar M R
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4. Treatment for Fistula | Fistula Laser Surgery | Patient Testimonial
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5. Anal Fistula | Surgery Online Video Lectures | Medical Student | V-Learning™ | sqadia.com
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6. Fistula | fistula laser treatment #definitecure
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