ANAL-FISTULAFistula is tract in the anal canal and rectum. Anal canal consists of different layer of muscles and fatty cushion .The disease takes place due to infection of anal glands. There are many glands in the anal canal. When one of these glands gets infected then abscess take places. This abscess bursts in the surrounding area of anal canal and pus comes out through a hole or opening. Then pus and blood comes out through this opening. The discharge point can be any where around the canal including hip and scrotum or in case of female in the surrounding area of vagina. Occasionally cancer in the rectum or anal canal can give rise to abscess or fistula. Fistula can be of different types like simple and complex fistula. Complex fistula has different varieties. Degree of complexity depends on to what extent the fistula tract has travelled through different muscle layers and how  far deep it has entered. There are three symptom of fistula namely, swelling, pain and periodic discharge. These symptoms remain dormant for few months then recurs again. Colonoscopy, anal endosonography and MRI test can be done to delineate the fistula tract.

Treatment: only treatment option is operation. In complex fistula staged operation needs to be done. Depending on the complexity 2-6 times operation with application of Seton may be required. Sometimes colostomy is required to make the operation successful. 1-2 weeks of gap is required in between two stages. It is common to get a fistula recurrence.  Fistula operation needs long time to heal. One and a half to three months time is required. In last twenty years we have done few thousands of fistula operation with success. A negligible (1-3%) percentage of patients had recurrence. International study shows (7-15%) recurrence.

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