Anal fistulas are usually typically treated with surgery. A colon and rectal surgeon performs the procedure. The purpose of the procedure is to strike a balance between removing the fistula and maintaining the anal sphincter muscles, which, if injured, could lead to incontinence.
Fistulotomy– A fistulotomy is used to treat fistulas that have no or little involvement of the sphincter muscle. The skin and muscle over the tunnel are sliced open to change it from a tunnel to an open groove in this surgery. The fistula tract can then repair from the bottom up.
Seton implanting– In the case of a more complicated fistula, the surgeon may need to use a seton, which must be left in place for at least 6 weeks. A second procedure is nearly often performed once a seton is implanted:
- A fistulotomy
- An advanced flap operation
- Lift procedure (the doctor opens the skin above the fistula and ties the fistula)
Injecting stem cells– This is a new treatment for Crohn’s disease fistulas. Before the procedure, your colorectal surgeon will go over all of your options with you.
Fistula surgery– It is typically performed as an outpatient procedure, meaning the patient can return home the same day. Patients with big or deep fistula tunnels may need to stay in the hospital following surgery for a while. The removal of some fistulas may necessitate multiple procedures.
Surgery works successfully for the majority of fistulas. Your surgeon may advise that you soak the damaged area in a warm bath, known as a sitz bath, and take stool softeners or laxatives for a week after the surgery.