CHRONIC ANORECTAL CONDITION
Anal Fistula
An abnormal tunnel connecting the anal canal to the skin near the anus, usually a sequel to a perianal abscess. Dr. Samhitha Reddy offers the full range of fistula treatments, including advanced sphincter-preserving techniques.
ABOUT THIS CONDITION
What is Anal Fistula?
An anal fistula is a small tunnel with one internal opening inside the anal canal and one external opening on the skin near the anus. It is most commonly caused by a perianal abscess that did not heal properly, leaving a persistent infected tract. Symptoms include chronic pus discharge, pain, and recurrent infections. Anal fistula treatment requires expertise in sphincter mapping and the selection of the correct surgical technique. Dr. Samhitha Reddy, one of the best anal fistula surgeons, offers every recognised fistula procedure, from simple fistulotomy to the most advanced minimally invasive options, tailored individually to tract complexity and sphincter involvement.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Previous perianal abscess, the most common cause
- Crohn's disease affecting the perianal region
- Tuberculosis of the perianal tissues
- Cryptoglandular infection of an anal gland
- Radiation therapy to the pelvic area
- Trauma or prior surgery in the anal region
CLINICAL DETAILS
KeyFacts
Intersphincteric, trans-sphincteric, suprasphincteric, extrasphincteric, determines technique
Endoanal ultrasound used to map tract and sphincter involvement before surgery
Fistula-tract Laser Closure, available at selected centres including Lux Hospitals
Gold standard for low simple fistulas, opens the tract to allow healing
Sphincter-preserving surgery for trans-sphincteric fistulas with low incontinence risk
Fistula surgery is covered by most major health insurance policies
HOW WE TREAT IT
Treatment Approach
Individualised Fistula Treatment, Sphincter Preservation First
Anal fistula surgery demands precision. For low fistulas, fistulotomy or fistulectomy provides definitive cure. Complex and high fistulas are managed with sphincter-preserving techniques, LIFT, advancement flap, VAAFT, FiLaC laser, or fistula plug, protecting continence while achieving durable closure. Dr. Samhitha selects the optimal approach based on endoanal ultrasound mapping.
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Endoanal Ultrasound Mapping
Dr. Samhitha uses endoanal ultrasound to precisely map the fistula tract, its Park's classification, sphincter involvement, and any secondary extensions before planning surgery.
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Simple Fistulas: Fistulotomy / Fistulectomy
The fistula tract is laid open (fistulotomy) or excised (fistulectomy) and allowed to heal by secondary intention. Highly effective for low intersphincteric and superficial fistulas.
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Complex Fistulas: Sphincter-Preserving Surgery
LIFT Procedure, Endorectal Advancement Flap, VAAFT, FiLaC laser, or Fistula Plug/Fibrin Glue, all preserve the sphincter while closing the fistula tract. Selection depends on tract anatomy.
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Staged Approach with Seton
A seton (surgical thread) is placed through the tract in stages, either as a draining seton for complex fistulas or a cutting seton, to achieve gradual closure while protecting sphincter function.
AVAILABLE TREATMENTS
Treatment Options
Fistulotomy
A surgical procedure where the fistula tract is laid open along its length, allowing healing by secondary intention while minimising recurrence.
Seton Placement
Insertion of a surgical thread or material through the fistula tract to maintain drainage, promote fibrosis, and gradually divide or preserve the sphincter muscle.
LIFT Procedure
Ligation of the intersphincteric fistula tract via an intersphincteric approach, aiming to close the internal opening while preserving sphincter integrity.
Fistulectomy
Complete excision of the fistulous tract, often resulting in a larger wound, with healing occurring by secondary intention.
Endorectal / Endoanal Advancement Flap
Mobilisation of a rectal mucosal or anodermal flap to cover the internal fistula opening after tract clearance, preserving sphincter function.
VAAFT
Video-assisted technique using a fistuloscope to directly visualise the tract, allowing internal closure and destruction under endoscopic guidance.
FiLaC
A sphincter-preserving procedure where a radial-emitting laser probe is used to obliterate the fistula tract via controlled thermal energy.
Fistula Plug / Fibrin Glue
Biologic or synthetic materials are inserted into the tract to occlude it and promote healing without surgical division of the sphincter muscle.
COMMON QUESTIONS
Frequently Asked
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