In most cases, people first develop a perianal abscess or pus collected eruption that is caused by the infection of the mucous glands in the inner wall of the anal canal that later develops into an anal fistula. Next, a sudden mild to moderate swelling may occur that is painful with tenderness.

There are various causes for the formation of a fistula, some as follows:

• ● Sexually transmitted diseases
• ● Cancer
• ● Crohn’s disease (inflammation of the gastrointestinal tract)
• ● Trauma
• ● Radiation for cancer treatment
• ● Diverticulitis (inflammation of the large intestine with small spotted pustule formation)
• ● Tuberculosis

You might see the following symptoms if you have a Fistula:

• ● Bleeding
• ● Frequent anal pus formation or abscesses formation
• ● Fatigue, fever with chills
• ● Pain and swelling around the anus
• ● Pain during passing stool
• ● Irritation of the mucous membrane while passing stool
• ● Blood in stool
• ● Malodour of stool
• ● Pus around the anus

Your doctor will look for a hole in the skin or the path of the fistula during your anal examination. The depth and direction of the fistula will be noted during a detailed examination. Sometimes, the fistula is not visible from the outside and might need investigative examinations.

• ● Anoscopy is a procedure that uses special equipment to examine the inside of the anus and rectum.
• ● Your doctor may also request an ultrasound or MRI scan of the anal area to observe the fistula better.
• ● An anesthesia test may sometimes be needed to be examined by the surgeon in the operating room.
• ● Other tests such as X-rays, blood tests, and even a colonoscopy might be recommended by your doctor.

Anal laser fistula treatment has other names such as FiLaC and laser ablation of the fistula tract (LAFT). This has received increasing attention in the past decade with the delivery of 360° laser surgery. Laser ablation is a sphincter-saving technique.

After the surgery is completed, you will be taken to the observation room to recover. Regular monitoring of the vitals to avoid any post-surgical complications is done. Once you can stand, you can go home, even if on the same day. Your doctor will give you instructions for wound care and other home preventive measures.

The laxative recommended by the doctor can help soften the stool and relieve discomfort. A sitz bath can also be used to reduce irritation and discomfort in the anal area. It is recommended that you sit in a shallow warm bath several times a day for 10–20 minutes each time. This relaxes the sphincter and promotes healing. You can resume your normal life 4–5 weeks after the operation.

Laser treatment of fistulas preserves the sphincter; therefore, the chance of incontinence after surgery is much lower than that of a fistula incision. It is more conservative and heals faster with lesser chances of postoperative infections.

The following are some other treatments:

• ● Fistula incision
• ● A flap advancement surgery is done to seal the fistula with a flap or tissue piece, just like removing a trap from the rectum.
• ● LIFT surgery is done where the skin is opened with the retraction of the sphincter muscles and suturing of the fistula.

An anal fistula is a disease that requires the respect and timely and accurate treatment of professional surgeons. They often deal with these diseases, and it is best to do it in a professional rectal center.

In this process, the skin and muscles above the tunnel open from the tunnel into an open groove, allowing the fistula to heal from the bottom.

Fistula tracts smaller than 30 mm were associated with a primary healing rate of 58.3%, while fistula tracts larger than 30 mm healed only in 16.6% of cases. So, laser closure is safe. It is an effective treatment for transsphincteric anal fistula.

Laser ​treatment does not cause any pain or bleeding. It is done at the doctor’s office and does not need admission to the hospital. Hence, don’t worry as you can head home the same day after the procedure.