An anal fistula is a passage connecting the rectum with another surface, usually skin, as shown in the image below.
An anal fistula is often preceded by an anal abscess, where the abscess / infection subsequently breaks out to the skin surface and the rectum.
Once the fistula is present, it is not very likely that it will heal spontaneously.
An anal fistula therefore usually requires some form of surgery. The type of surgery depends on how the fistula runs in relation to the sphincter muscle.
To avoid damaging the sphincter muscle when performing the operation, it is crucial to identify, as detailed as possible, how the fistula runs in relation the sphincter so that surgery can be carefully planned.
Mapping the fistula is best done by examination of the rectum and carefully probing the fistula by a consultant surgeon and by a so-called MRI scan at the hospital.
Your consultant surgeon will refer you to the MRI scan at the hospital.
In the event that it is a short superficial fistula, surgery can be done under local anesthesia in your consultant surgeon’s clinic.
If there is a more complicated course of the fistula involving the sphincter, surgery is done under general anesthesia at the hospital.