A perianal fistula surgery (anal fistula) is the development of an abnormal pathway or tunnel that should not exist between the internal part of the anus and the external skin. This condition usually occurs following an anal abscess that was either neglected or inadequately treated, significantly impacting the patient’s quality of life. In our clinic, our priority in fistula treatment is to apply modern and permanent surgical approaches that preserve the anal muscles (sphincter) without exposing our patients to the laborious processes that can last for months.
What is fistula surgery without the use of a Seton?
In traditional fistula treatments, the “seton” method is frequently used. This involves passing a string (seton) through the fistula tract, which is then gradually tightened over a period of several months. This process is quite arduous, exhausting, and restrictive for the patient’s daily life. Fistula surgeries performed without a seton aim to save the patient from this distressing, months-long treatment cycle. With advanced surgical techniques, the fistula tract is cleaned and repaired in a single operation without the need for long-term apparatus usage.
How is fistula surgery performed with the Flap method?
The fundamental approach we successfully apply in our clinic, which preserves anal physiology, is the “Fistulotomy + Flap” combination. In this method, the fistula tract (tunnel) is first carefully separated from the surrounding tissues and completely removed (fistulotomy). Subsequently, the internal opening—which is located inside the intestine and is the primary source of infection—is covered and closed using the patient’s own healthy tissue (flap).
This repair is achieved by selecting the most suitable healthy tissue based on the patient’s anatomical structure, the location of the fistula, and its depth. The greatest advantage of this procedure is that the muscles responsible for gas and stool control (sphincter) are strictly not cut; it is a sphincter-saving (muscle-preserving) procedure.
How long does fistula surgery take?
The duration of fistula surgery varies depending on the complexity of the disease, the length of the fistula tract, and the planned repair. However, operations performed in our clinic using muscle-preserving techniques take an average of 45 to 60 minutes, depending on the case. After a short period of rest in their rooms following the procedure, our patients can be comfortably discharged on the same day or the next day, depending on their condition.
Is there pain after fistula surgery?
The muscle-preserving nature of the flap method we apply significantly reduces the level of pain experienced after surgery. Since no damage or incisions are made to the anal muscles, our patients are much more comfortable during bowel movements compared to traditional methods. Any mild aching or sensitivity that may occur due to tissue healing in the procedure area can be easily controlled with the standard painkillers we provide.
What are the risks of fistula surgery?
The biggest reason patients with fistulas avoid surgery is the possibility of damage to the anal muscles in traditional operations and the fear of permanent gas or stool incontinence that may develop as a result. However, in surgeries we perform with the “Fistulotomy + Flap” method, the risk of gas and stool leakage is almost entirely eliminated because the muscles are fully protected. Thanks to this modern approach, safe treatment is provided without disrupting the anatomical structure.
How to use the bathroom after fistula surgery?
After surgery performed with the flap method, patients can fulfill their toilet needs normally and without problems. Since muscle functions are preserved, issues like incontinence do not occur. The most important point to consider is hygiene: after using the toilet, the area should not be wiped with harsh toilet paper. Instead, it should be gently washed with lukewarm water and dried softly or with a hair dryer; this is crucial for the flap tissue to heal healthily. Additionally, to avoid straining the sutures, a high-fiber diet to prevent constipation is an absolute must for the process.
Fistula surgery prices
Fistula surgery prices vary according to the type of fistula (simple, complicated, horseshoe, etc.), whether it is single-tract or multi-tract, the anesthesia method to be applied, and the equipment of the center where the operation will be performed. Since anal fistulas show different locations and characteristics in every patient, we recommend scheduling a detailed examination appointment at our clinic to create the most accurate personalized surgical plan and provide clear pricing information.
