![]() ![]() This may require removal of the sutures and even drainage of the wound. ![]() The main problem with this operation is infection of the wound. A temporary stoma (bag) may be required to ensure better healing with any further attempted repair. This would be at a time when swelling and infection has resolved. It is possible for the repair to break down.A second operation may be performed. This operation is performed with a cut in the gap between the anus and the vagina. If the anal sphincter muscle is also deficient then this will usually require repair as well. Other causes include anal abscess, surgical trauma, Crohn’s disease, radiation therapy, congenital and a malignant tumour.Īn operation will be required to close the openings in the vagina and the anus. If this is unrecognised or the initial repair fails to heals a fistula can result. With a vaginal delivery there can be a tear between the vagina and the anus. The most common is related to childbirth. This is one of the reasons that a complex fistula where a lot of the muscle is involved may have a staged treatment with more than one operation.Īn ano-vaginal fistula is an abnormal connection between the anus and the lining of the vagina.Īno-vaginal fistula can arise from many conditions. This could be to flatus of potentially to faecal material. ![]() If this were to happen control (continence) may be affected. Care must be taken not to cut or damage too much of this muscle. This muscle is a ring around the anus that closes the opening and prevents leakage. The main risk of surgery is damage to the anal sphincter muscle. About 10% however are complex and may require a more complex operation and even multiple operations to heal. Most fistulae are simple and can be fixed with a single operation. A surgeon in the setting of Crohn’s disease may be more likely to not perform a cutting operation and use a seton. They are often hard to heal and have a tendency to recur. If this heals no more faecal contamination of the fistula tract can occur and the fistula will heal.įistulas in Crohn’s disease are more difficult to treat. This operation involves covering the anal opening of the fistula with the lining of the anus or rectum. As it cuts through slowly the muscle is cut, but heals at the same time so that the muscle ring does not spring apart. This allows drainage and it will slowly cut through. This involves placing a stitch through the fistula and leaving it in place for many weeks. The word seton is derived from the Greek word for hair. This involves cutting open the fistula and creating a wound that is allowed to heal from its raw base to finally heal at the skin. If too much of this muscle is cut it is possible for there to be reduced bowel control and accident either to flatus or faeces. In particular the surgeon will need to assess the amount of anal sphincter muscle involved by the fistula. ![]() The operations performed are varied and principally depend on the type of fistula.However there would be a risk of recurrent anal infection with no treatment.If this is the case then no treatment may be required.A fistula may not be associated with any symptoms.This is a tract or tunnel.Īnal fistula are usually the result of an abscess around the anus. An example would be a connection between the urine bladder and the bowel.Īn anal fistula is an abnormal connection between the skin around the anus and the lining of the anal canal. This can occur between a variety of different organs. A fistula is an abnormal connection between 2 parts of the body. ![]()
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