Laser Surgery Fistula

What is Fistula?

A fistula is an abnormal connection between an organ and another structure. The most common location for a fistula is around the anus, called anal fistulas. An anal fistula is a tunnel that runs from inside the anus to somewhere in the perianal skin. It usually follows perianal infection (such as hair root infection, boil or abscess) that didn’t heal the right way.

The second most common location is between two loops of intestine. Fistulas can also form between the:

  • Rectum and vagina
  • Intestine and skin
  • Intestine and bladder

Perianal fistulas are subclassified by their location and complexity (Figure 1). Anatomically there are two sphincters (internal and external), which are muscles that enable you to control bowel movements.

Fistulas can form across 1 or both sphincters (Figure 2). They also can form above or between the sphincters. Some fistulas start high up in the rectum and do not cross the sphincters at all. Fistulas can be simple (single tunnel) or complex (multiple tunnels).

If the fistula is located in the lower anal region and is subcutaneous or submucous in nature, it is classified as a low-level fistula. However, if it affects the higher anal or the pelvic-rectal region, it is considered as a high-level fistula. Depending on its effects on the sphincter muscles, a fistula is further classified as intersphincteric, transphincteric, suprasphincteric or extrasphincteric.

What is Appendix?

The appendix is a narrow, small, finger-shaped portion of the large intestine that is generally situated near junction of small and large intestine (Cecum) on lower right side of the abdomen.

Appendicitis

Appendicitis is a sudden inflammation of the appendix. Although the appendix does not seem to serve any purpose, it can become diseased and, if untreated, can burst, causing infection and could be even fatal.

Anal Fistula: Symptoms and Treatment

An anal fistula is a passageway that develops between the anus and the skin. This usually develops because of an anal infection.

Symptoms of anal fistulas include fever, bleeding from the anus or skin where the fistula has occurred, constipation, pain with stool passing, and swelling of the skin around the anus. Surgery is the only treatment that will close the anal fistula.

Vaginal Fistula: Symptoms and Treatment

A vaginal fistula is a passageway that develops between the vagina and other organs in the pelvis. Vaginal fistulas can be caused by having children, Crohn's disease, previous surgeries, or cancer. There are several types of vaginal fistulas, including:

  • Ureterovaginal fistula - which develop between the vagina and ureters
  • Urethrovaginal fistula - which develop between the vagina and urethra
  • Colovaginal fistulas - which develop between the vagina and the colon
  • Enterovaginal fistula - which develop between the vagina and small intestines
  • Rectovaginal fistula - which develop between the vagina and rectum
  • Vesicovaginal fistula - which develop between the vagina and bladder

What is the best treatment for fistula?

“There is no fistula treatment without surgery as the fistula cannot heal on its own,” said Dr. A. Jina

Meera was worried when she heard her fistula treatment cannot be done with just conservative management.

Dr. A. Jina was quick to reassure her and explained how fistula surgery is a simple procedure.

Here are the two fistula treatment methods he recommended –

1 - Minimal-access method: Minimally-invasive surgery like VAAFT surgery causes less pain, is safer with no external scars, and has a quicker recovery period.“It is a day-care surgery so you can be discharged the same day and resume work the next day.”

2 - Open surgery method: The more conventional open-surgery method, also known as a Fistulectomy, lessens the chances of fistulae from recurring.“The recovery period may be longer in this method as it can take 4-6 weeks to heal post-surgery.” Fistula treatment without surgery is not a recommended option as fistulae rarely heal by themselves.

It is important you consult your surgeon as early as possible for appropriate fistula treatment.