A fistula is a small channel that can develop between the end of the bowel and the skin near the anus. A fistula can cause bleeding and discharge when passing stools - and can be painful. A fistula can occur after surgery to drain an abscess. In some cases, a fistula causes persistent drainage. In other cases, where the outside of the channel opening closes, the result may be recurrent abscesses. The only cure for a fistula is surgery.
Possible symptoms include:
Pain, which is usually constant, throbbing and worse when sitting down
Skin irritation around the anus, including swelling, redness and tenderness
Discharge of pus or blood
Constipation or pain associated with bowel movements
The type of surgery will depend on the position of your fistula. The options include:
Fistulotomy. This is used in 85-95% of cases and involves cutting open the whole length of the fistula in order for the surgeon to flush out the contents. This heals after one to two months into a flattened scar.
Seton techniques. A seton is a piece of thread which is left in the fistula tract. This may be considered if you are at high risk of developing incontinence when the fistula crosses the sphincter muscles. Sometimes several operations are necessary.
Advancement flap procedures. This option is usually when the fistula is considered complex, or is there is a high risk of incontinence. The advancement flap is a piece of tissue that is removed from the rectum or from the skin around the anus. During surgery, the fistula tract is removed and the flap is reattached where the opening of the fistula was. The operation is effective in about 70% of cases.
Fibrin glue. This is currently the only non-surgical treatment option. The glue is injected into the fistula to seal the tract, and then the opening is stitched closed. It is a simple, safe and painless procedure, but long term results for this method are poor. Initial success rates as high as 77% drop to 14% after 16 months.
Bioprosthetic plug. This is a cone shaped plug made from human tissue, which is used to block the internal opening of the fistula. Stitches keep it in place. However, this does not completely seal the fistula, so that it can continue to drain. New tissue usually grows around the plug to heal the fistula. Two trials show success rates of over 80% for this method, but long term success rates are uncertain.
At our Gastro Clinic Dr. Kapileshwer Vijay is skilled and experienced fistula surgeon, doctor in Jaipur, who provide best and top notch fistula surgery and treatments to patients at affordable cost. If you want to get best fistula surgery, then you must visit at our Gastro Clinic in Jaipur, Rajasthan, India.