How is recurrent fistula treated?
If the recurrent anal fistula proved to be a simple intersphincteric fistula, then lay-open of the tract with curettage of its bed is usually sufficient, unless the risk of incontinence was high, then a sphincter-saving procedure such as LIFT should be attempted.
How many times fistula can reoccur?
The chances of recurrence in different types of anal fistulae range between 7\% and 50\% [16-18]. Therefore, most patients require multiple surgeries. Due to a high failure rate in fistula operations and increased risk of recurrence, this condition needs to be studied in detail.
Do fistulas keep coming back?
Unfortunately, despite proper treatment and complete healing, an abscess or a fistula can come back. If an abscess comes back, it suggests that perhaps there is a fistula that needs to be treated. If a fistula comes back, additional surgery will likely be required to treat the problem.
Is fistula in ano common?
An anal fistula (also commonly called fistula-in-ano) is frequently the result of a previous or current anal abscess. This occurs in up to 40\% of patients with abscesses. A fistula is an epithelialized tunnel that connects a clogged gland inside the anal canal to the outside skin.
Why does fistula occur in Ano?
An anal fistula most often happens from an anal gland that has developed a pus-filled infection (abscess). A fistula can also happen with certain conditions, such as Crohn’s disease. Or it may happen after radiation therapy for cancer. Injury to the anal canal and surgery can also cause anal fistulas.
Can a fistula recur after treatment?
The high extension of a fistula, with erroneous diagnosis and faulty treatment strategy, can also lead to recurrence. All forms of high extending fistulae are difficult to diagnose and manage; some forms are more challenging to deal with than the others.
What increases the risk of fistula recurrence?
Another factor related to fistula anatomy that increases the risk of recurrence is the circumferential involvement of the fistula. This pattern leads to the formation of ‘horse-shoe shaped’ fistula [19].
What happens if a fistula is left open?
If this type of fistula is laid open, it would lead to total incontinence, incomplete closure, and consequently will have a higher risk of recurrence [18-19]. Another factor related to fistula anatomy that increases the risk of recurrence is the circumferential involvement of the fistula.
Why is it important that the surgeon ensure complete course of fistula?
It is important that the surgeon ensures complete course of the fistulous tract, including its ramifications. A failure to recognize and excise the complete fistulous tract can leave behind granulation tissue, which will lead to the persistence of the fistulous tract.