A small tunnel that won’t heal on its own, treated with the technique best suited to its position and complexity.
Anal fistula surgery treats a tunnel that has formed between the bowel and the skin, using the technique best suited to protect continence and support long-term healing. The right technique depends heavily on exactly where the fistula runs relative to the sphincter muscle.
What is an anal fistula?
An anal fistula is an abnormal channel connecting the anal canal to the skin surface, most often the result of a previous abscess, typically causing ongoing discharge and recurring infections until it’s properly treated.
Symptoms worth getting checked
- Persistent discharge near the anus
- Recurring abscesses in the same area
- Pain and swelling
- Skin irritation from ongoing discharge
- A visible opening on the skin near the anus
- Symptoms following a previous abscess that never fully settled
Your treatment options
The complexity of the fistula, specifically its relationship to the sphincter muscle, determines which technique is appropriate.
If there’s an active infection, this comes first to relieve pain and settle things down before definitive fistula treatment is planned.
A soft thread placed through the fistula tract to keep it draining and controlled, often used for more complex fistulas, sometimes as a staged step towards further treatment.
For simple, low fistulas, opening the tract to allow it to heal from the inside out — a well-established, effective option in the right cases.
For more complex fistulas close to the sphincter muscle, a technique designed to close the fistula while protecting continence.
Recovery & aftercare
Most fistula surgery is day-case. You’ll be given a clear wound-care routine, guidance on bathing and hygiene, and a structured follow-up plan, particularly important for tracking healing over the following weeks.
If you’ve had more than one abscess drained in the same area, there’s a good chance an underlying fistula needs treating directly rather than just draining the infection each time.
Recovery, honestly
Simple fistulotomy: healing over several weeks, most people return to normal activity quickly with some ongoing wound care. Seton or staged treatment: a longer process by design, sometimes months, because it’s prioritising your continence over speed. Mr Kimble will always tell you which category your case falls into and why, this isn’t a condition where “just get it over with quickly” is always the right approach.
