Anal Fistulas

Fistula is the name for a channel through which things can pass. Fistula is formed as an abnormal channel between the inner surface of the anal canal and the opening of the anus. This channel allows flow of fecal matter, pus and blood which keeps the area infected and results in pain, bleeding, pus drainage and discomfort during the bowel movement.

The anal glands which make fluids get blocked due to many reasons and this produces bacteria which causes infection in the surrounding tissue and creates abscess. If this abscess is not treated in time then the abscess creates a path for itself to move out of the body. This path is known as fistula.

Fistulas can have many reasons like a sexually transmitted disease, tuberculosis, trauma, rectal cancer, HIV, AIDS, Syphlis, Ulcer, Surgical Complication, Injury to the rectum wall etc. The symptoms for fistula are discomfort while defecating, blood and pus from the anus, fever, chills and fatigue, foul smelling liquid from the abscess opening, recurrent chronic anal abscess. One must not ignore these symptoms as a small problem can become much more complicated if left untreated.

The first thing that you should do in such cases is to consult a good ano-rectal surgeon who would do a physical examination and diagnose the disease. Most of the anal fistulas are visible from the outside but in order to see the complete path of the fistula the following investigations are of great help - MRI, Contrast CT Fisultogram. Once the diagnosis is confirmed then the line of treatment would be decided.

Treatment Options

The most common surgery for Fistula is known as Fistulotomy where the surgeon cuts the channel and completely drains the pus and removes the infected tissue. The surface of the channel is destroyed surgically so that scarring takes place and finally when the healing happens the channel collapses and the cavity is finished. The surgery takes about 30 - 45 minutes and the patient is discharged from the hospital in 1-2 days time. The entire healing takes about 2 weeks. Sometimes the surgeon may use a stapler to close the opening of the fistula channel into the internal body and then destroy the channel using electrocautery.

Laser Surgery for Fistula is a new technique which is completely non-invasive and can be done in OPD settings without requiring hospitalization. However for insurance patients one day of hospital stay may be required for claiming the insurance. In this surgery a Diode Laser Machine is used which is similar to the machine which is used in Hair Removal procedures by the Dermatology centres. This machine works at a different frequency than the hair removal laser and delivers different amounts of energy so that the laser achieves the same goals as an open surgery but without any pain or bleeding.

Since there are no cuts in Laser Surgery for Fistula your post procedure visit to the doctor would be minimal and you would be able to do normal work from the next day onwards. It has been seen that the recurrence rate in Laser Surgery is lesser than the open surgery and the recovery period is much shorter.

Best Doctors and Cost

Dr Majid Rasool Wani is one of the most qualified and extensively trained General & Laparoscopic Surgeon for doing Laparoscopic Appendix Surgery at Bahra Hospital. The cost of Laser Fistulectomy is Rs. 85,000 - 1,20,000 while the cost of normal fistulectomy is Rs. 75,000 - 90,000. The Laser Surgery is done in daycare and the patient goes home the same day. For open surgery the hospital stay is 1-2 days. The recovery in Laser Surgery is much quicker and the patient is back to normal activities within 2-3 days of the surgery. Fistal surgeries can be really difficult in some of the patients. It is always best to get an MRI Fistulogram before planning the surgery. Sometimes redo surgery might be required within 3-4 months of the first surgery.

If you have an individual health insurance policy then this surgery is covered after a period of 2 years from the date of inception of the policy. However if you are a beneficiary of company given policy then the surgery is covered from day one. Always go through the terms of your health insurance policy like room rent capping and co-payment to avoid any kind of financial shocks later on.

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