Fistula in ano A.K.A Anal fistula is a small tract or tunnel between the skin and anus. This usually starts as a small boil in the peri anal region which ruptures and discharges this fluid or pus. Unless addressed properly this may stay for months or even years with on and off discharge.
Anal canal is lined by mucous glands which secrete lubricant fluid. When one of these glands get infected they became an abscess forming a pus collection. Gradually over time this perianal abscess ruptures forming a connection with the skin and internally with the anal canal forming a fistula. The infection can also be caused because of underlying Crohn’s disease, tuberculosis and sexually transmitted diseases.
Clinical examination forms a main base for diagnosis of fistula in ano. Adjuncts to confirm the diagnosis include a fistulogram preferably an MRI fistulogram.
Depending on the presence of pus, the amount of pus , length and complexity of tract the fistula surgery is done one or two stages. In two stages surgery first step is partial removal of tract with placement of a seton (medicated thread) sround followed by complete removal in second stage surgery.
Fistula laser closure or commonly known as FiLAC is the procedure for the anal fistula treatment. Burning or ablating the anal fistula tract using a high energy laser bean forms one of the safest and advanced treatment for anal fistula.