What is a Fistula-in-Ano?
An anal fistula is an abnormal tunnel connecting the inside of the anal canal to the skin outside the anus. It usually develops after an anorectal abscess that didn't heal properly. Most fistulas require surgery and do not heal on their own.
Symptoms
- Persistent pain and discomfort around the anus
- Swelling, redness, and tenderness near the anus
- Discharge of pus, blood, or foul-smelling fluid
- Recurring anorectal abscesses
- Skin irritation around the fistula opening
- Pain during bowel movements
Types of Fistula
- Simple (low) fistula – Single tract, does not involve much sphincter muscle
- Complex (high) fistula – Involves significant sphincter muscle, more challenging
- Suprasphincteric fistula – Passes above the puborectalis muscle
- Horseshoe fistula – U-shaped tract extending around both sides of the anus
Advanced Treatment Options
- LIFT (Ligation of Intersphincteric Fistula Tract) – Sphincter-preserving, excellent results for most types
- VAAFT (Video Assisted Anal Fistula Treatment) – Miniature camera to visualize & treat the tract internally
- Fistulotomy – Laying open the tract for simple low fistulas
- Seton placement – Staged approach for complex sphincter fistulas
- Ksharsutra – Traditional Ayurvedic thread treatment with very low recurrence
Why VAAFT?
- Direct visualization of the entire fistula tract
- Minimal sphincter damage — preserves continence
- Shorter hospital stay and faster recovery
- Higher success rates for complex fistulas
- Lower recurrence than traditional open surgery