a small discharging opening near the bottom. There may have been a preceding abscess near the bottom that has required surgical drainage. Some pain prior to discharge is common.
most such cases are spontaneous. Rarely fistulae might be related to Crohn’s Disease, malignancy, radiotherapy, TB, hidradenitis suppurativa, or previous major pelvic surgery.
examination under anaesthetic or an MRI scan or both.
- there are a variety of options (lay open the fistula track, loose or cutting setons, ‘LIFT’ procedure, insertion of a fistula plug, formation of an advancement flap). Some of these options are very simple and some slightly more complicated. The exact procedure offered will take into account the complexity of the fistula, the sex of the patient, the bowel control of the patient and what previous attempts might have been undertaken.
- the goal of treatment is to prevent further abscess formation, preserve good bowel control and try to get the fistula to heal.