Surgery for Anal Fistula

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What is an anal fistula?

An anal fistula is an abnormal connection between the lining on the inside of your anal canal (back passage) and the skin near your anus.

Most anal fistulas are caused by an abscess (a collection of pus) that has developed in your anal canal. The pus can drain away onto your skin on its own or by an operation. A fistula happens when the track made by the pus on the way to the surface of your skin stays open.

What are the benefits of surgery?

You should no longer have any infection or pain.

Are there any alternatives to surgery?

Most anal fistulas do not heal without surgery.

What does the operation involve?

The operation is usually performed under a general anaesthetic but various anaesthetic techniques are possible. The operation usually takes 15 to 30 minutes.

To lessen the risk of bowel incontinence (when you pass a bowel movement without wanting to) your treatment may involve several operations over a number of months.

The type of surgery you need will depend on where the fistula is.

If the fistula is below or crosses the lower part of the sphincter muscles (the muscles around your anal canal that control when you open your bowels), your surgeon will cut the fistula open to your skin and leave your wound open so that it can heal with healthy tissue.

If the fistula has branches that pass through the upper part of the sphincter muscles, your surgeon may instead place a special stitch (called a seton stitch) in the fistula to allow pus to drain easily. The fistula may be suitable for treatment with special glue, clips or a plug made from pig-bowel tissue.

If the fistula reaches above your sphincter muscles, you may need to have a temporary colostomy (your large bowel opening onto your skin). However, this is not common.

How soon will I recover?

You should be able to go home the same day or the day after.

Rest for a few days, walking as little as possible, to help your wound to heal.

You should be able to return to work as soon as you can move about and sit freely.

The wound often takes several weeks to heal completely and you may need to wear a pad until then.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a full recovery and can return to normal activities. For a small number of people the fistula can come back.

What complications can happen?

Some complications can be serious and can even cause death.

General complications of any operation

  • Pain
  • Bleeding
  • Infection of the surgical site (wound)
  • Unsightly scarring of your skin

Specific complications of this operation

  • Difficulty passing urine
  • Involuntarily passing wind or loose faeces
  • Bowel incontinence

Availability

NHS/Private

Pricing*

Consultant
£249
Anaesthetist
£145
Hospital
£1,917
Guide price
£2,311

*The prices shown are minimum guide prices only. Diagnostic scans and investigations are not included unless otherwise stated. The exact cost of treatment will be made clear to you before you proceed.

This document is intended for information purposes only and should not replace advice your healthcare team gives you. This information is published under license from EIDO Healthcare UK and is protected by copyright. Other than for your personal, non-commercial use, you may not copy, print, download or otherwise reproduce it.

An anal fistula can cause continued infection and pain. Symptoms usually get worse without surgery.

What to do next
  1. Talk to us about ways to pay, either insured or self-pay, and find out if you need a referral from your doctor.
  2. If you need one, ask your doctor for a referral letter.
  3. Call us to book an appointment with a consultant.
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I can’t thank everyone enough for the amazing care given. Such lovely attentive nurses. I will definitely recommend St Hughs and Mr Riaz and his team. Brilliant hospital.

Could not fault anything about my stay in St Hughs. Everybody was wonderful. Thank you all.

Everybody was kind, considerate and a jolly bunch, which helps to put you at ease and gives you confidence in knowing that they know what they are doing. 5 stars.

All staff extremely kind, patient and friendly. A credit to the hospital. Thank you.

Very good hospital and very good staff. I have never met so many caring people in one place. The nursing was 1st class. The encouragement to walk was also very good.

I had an amazing experience during my time at St Hugh’s Hospital, from my initial consultation to the aftercare following my procedure. Communication with the cosmetic nurse was brilliant; every member of staff I met was kind respectful, caring and polite. My surgeon was fantastic, so professional and kind, I trusted his knowledge completely.