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Perianal Fistula

Perianal fistula is certainly one of the most complex, difficult anal conditions to treat.  A perianal fistula is an abnormal connection between the anal canal and perianal skin which manifests clinically as a small orifice in the skin close to the anus, where discharge keeps occurring.

The cause of this infection is not known, but it is more common in the presence of wounds (fissures) and diarrhoea.  Perianal fistulas can also occur for other reasons, such as tuberculosis and Crohn's disease, but these are less common causes. 

This condition is always treated surgically, with a view to removing the fistula while maintaining the integrity of the sphincters to guarantee the patient's continence.

Benefits of the Operation

The purpose of treating a perianal fistula is to prevent or eradicate sepsis without compromising the patient's continence. 

Latest generation CO² lasers can remove the abnormal connection, reducing surgical trauma and post operative pain, healing times and local inflammatory response.

Medical-technical description

Perianal fistulas are treated using different surgical techniques, the choice of which depends on the clinical characteristics of the fistula. The idea is to remove the fistula and leave it open to heal little by little.

About the operation

Perianal abscesses are drained under local anaesthetic on an outpatient basis.  The drain must always be ample. The alternative treatments for perianal fistulas are fistulotomy and fistulectomy.  Fistulotomy involves opening up the fistula without resection, and is indicated for intrasphincter fistulas. 

Resection of the fistula or fistulotomy is suitable for trans or extrasphincteral fistulas. When the external sphincter is significantly compromised, an elastic ligature should be performed, to achieve delay the procedure and thus prevent anal incontinence. 

The operation takes approximately 30 minutes.  Patients generally stay in the clinic for one day.


Before the operation

  • You must not eat or drink for 12 hours before your operation.
  • You must stop taking drugs such as aspirin, anticoagulants, anti-inflammatories and vitamin E one week before the surgery.
  • You must remove all metal objects during the operation (rings, bracelets, earrings, body piercings, etc.).

Post-operative care

  • You will require post-operative wound care on an outpatient basis.
  • It is recommended you wash the site thoroughly every day.
  • You will need to follow a special diet for a few weeks.
  • You will be ready to go back to work after 7-10 days.

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