Fistula
Proctology · fistula · anal fistula · diagnostics · treatment · Gdańsk
A fistula is an abnormal connection between body structures that normally should not be connected. The most common type in proctological practice is an anal fistula — a channel between the anal canal and the skin around the anus, causing discharge, pain or recurrent abscesses. Fistulas require medical assessment — untreated, they may enlarge or recur.
Do you have an abscess or discharge around the anus? Start with a proctology consultation. The doctor will assess whether this is a fistula and suggest the next steps.
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assessment of the course and qualification for treatment
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What is a fistula?
A fistula, Latin fistula, is an abnormal connection between two body structures that normally should not be connected — between organs, body spaces, or an organ and the skin. Fistulas may develop in different areas of the body: within the digestive, urinary or reproductive system, or on the skin.
The most common types include: anal fistula — between the anal canal and the skin around the anus; rectovaginal fistula — between the rectum and the vagina; urinary fistulas, for example vesicovaginal fistula; and intestinal fistulas — between sections of the intestine or between the intestine and the skin. Each type of fistula requires assessment by the appropriate specialist — a proctologist, urologist or gynaecologist — depending on its location.
Specialisation of Wyspa Medycyny Przyjaznej: our proctology team deals with anal and perirectal fistulas. Below you will find detailed information about this specific type of fistula.
What is an anal fistula?
An anal fistula is an abnormal channel that connects the inside of the anal canal with the skin around the anus. Purulent, mucous or faecal discharge may come out through this channel. A fistula most often develops as a consequence of an anal abscess — inflammation in the crypts of the anal mucosa or in the fatty spaces around it.
Not every fistula follows the same course. A surgeon or proctologist assesses its type based on examination and, if necessary, additional imaging tests. The type of fistula affects the choice of treatment method.
Important: an anal fistula usually does not heal on its own. Discharge, recurrent abscesses or pain around the anus require proctological or surgical assessment. Qualification for treatment is decided by the doctor after examination.
Symptoms most commonly reported by patients
- discharge — purulent, mucous or faecal — around the anus, often appearing and disappearing,
- pain or discomfort around the anus, worsening when sitting or passing stool,
- recurrent abscesses around the anus,
- itching, irritation or moisture of the skin around the anus,
- a palpable opening or depression in the skin around the anus,
- fever, if an active infection or abscess is present.
Types of anal fistulas
Fistulas differ in their course in relation to the anal sphincter muscles. This is key information for the surgeon planning treatment, because the type of fistula determines which method will be appropriate and how high the risk of complications may be.
Runs between the internal and external sphincter muscles. One of the most common types — with a relatively favourable course for surgical treatment.
Passes through both sphincter muscles. The choice of treatment method requires careful assessment because of the risk of affecting sphincter function.
Runs above the sphincters. Less common and anatomically more complex — requires detailed diagnostics.
Runs outside the sphincters. Very rare; requires investigation of the cause, for example Crohn’s disease or trauma, and specialist treatment.
When should you seek urgent medical help?
Most fistulas are chronic conditions requiring planned treatment. However, there are situations that require faster action.
Seek urgent medical help if you have:
- a large, rapidly growing abscess around the anus with severe pain,
- fever with chills and severe pain around the perineum or anus,
- swelling, redness and warmth spreading over an increasing area,
- difficulty walking, sitting or passing urine because of pain,
- general deterioration of wellbeing accompanying local symptoms.
A large abscess or infection of the perianal spaces may require urgent surgical intervention. If in doubt, see a doctor or go to an emergency department.
What does anal fistula diagnostics involve?
The basis is a proctological or surgical examination — the doctor assesses the location of the external opening and tries to determine the course of the fistula. Sometimes imaging tests are necessary, as they accurately show the anatomy of the fistula and its relationship to the sphincters.
Assessment of the anal area, detection of the external opening, anoscopy. Initial assessment of the fistula course.
Proctology consultation →Imaging shows the exact course of the fistula in relation to the sphincter muscles. It is crucial in complex fistulas.
Usually performed by the surgeon during the procedure — it helps determine the course of the tract and plan the treatment method.
Treatment of anal fistula
An anal fistula does not heal on its own. Treatment is surgical or procedural — its type depends on the course of the fistula, its complexity and sphincter condition. The method is chosen by the surgeon or proctologist during qualification.
The most common method for simple fistulas. It involves cutting open the fistula tract. The decision to use this method depends on the fistula’s course in relation to the sphincters.
Drainage using a thread passed through the fistula. Used in complex fistulas or as a treatment stage — it helps control infection before definitive surgery.
Mucosal advancement flap, LIFT, tissue glue, biological plug — used in complex fistulas when sphincter preservation is a priority. The choice depends on fistula anatomy.
The doctor discusses the treatment method, possible risks and recovery individually with each patient during qualification. Treatment of complex fistulas may sometimes require several stages.
What should you do if you suspect an anal fistula?
A fistula rarely “goes away on its own” — the earlier the medical assessment, the lower the risk of complications and recurrence.
The doctor examines the anal area, assesses whether it is a fistula and determines the next steps.
Book a consultation →If the fistula is complex or sphincter assessment is needed, the doctor orders MRI or anal ultrasound.
The surgeon or proctologist qualifies the patient for the appropriate method. The decision depends on the type of fistula and test results.
Fistula treatment →Proctologists and surgeons at Wyspa Medycyny Przyjaznej
Proctological and surgical consultations, diagnostics and treatment of anal fistulas.
surgeon, proctologist
Surgeon and proctologist providing diagnostics and treatment of anal diseases, fistulas, haemorrhoids and other proctological conditions.
surgeon, proctologist
Surgeon and proctologist providing proctological consultations and treatment of anal diseases.
surgeon, proctologist
Surgeon and proctologist providing proctological consultations and treatment of anal diseases.
Do you have discharge or a recurrent abscess around the anus?
Book a proctology or surgical consultation. The doctor will assess whether this is a fistula and suggest the next steps.
Frequently asked questions about anal fistula
Can an anal fistula heal on its own?
An anal fistula usually does not heal on its own. The fistula tract requires surgical or procedural treatment. Sometimes symptoms temporarily decrease, but without treatment the fistula usually recurs or enlarges.
What does an anal fistula look like from the outside?
Most often, a small opening or depression is visible in the skin around the anus, through which discharge may come out. Sometimes the surrounding skin is irritated, red or moist. The doctor assesses the lesion during examination.
Does an anal fistula always require surgery?
Treatment of an anal fistula is surgical or procedural in most cases. The type of method — from a simple incision to sphincter-sparing techniques — depends on the course of the fistula. Qualification is decided by the surgeon or proctologist after examination and imaging diagnostics.
What is a seton and when is it used?
A seton is a thread or drain passed through the fistula tract. It is used in complex fistulas when infection must be drained before definitive treatment, or when the risk of sphincter damage during a one-stage operation is too high.
Can an anal fistula recur after surgery?
Recurrence of a fistula is possible — the risk depends on the type of fistula, the method used and individual patient factors. The doctor discusses the risk of recurrence and possible treatment methods during qualification.
Can an anal fistula be a symptom of another disease?
Yes — an anal fistula may be one of the symptoms of Crohn’s disease or other inflammatory bowel diseases. Therefore, in recurrent or complex fistulas, the doctor may recommend broader diagnostics.
How long does anal fistula treatment take?
Treatment time depends on the type and complexity of the fistula. Simple fistulas may require one procedure and several weeks of healing. Complex fistulas may require several stages of treatment over time. Details are discussed by the doctor during qualification.
What do patients say after a proctology consultation?
★★★★★ 5.0 · ZnanyLekarz
“For several months I struggled with a recurrent abscess. I finally decided to have a consultation. The doctor calmly explained what a fistula is, what treatment looks like and what comes next. At last I had a clear answer.”
Andrzej K. · ZnanyLekarz“I was afraid of seeing a proctologist. It turned out there was nothing to be ashamed of — the doctor was professional and the examination was performed discreetly. I received a concrete action plan and could ask all my questions.”
Marta L. · ZnanyLekarz“The surgical consultation before fistula treatment gave me a complete picture of the situation. The doctor explained why the procedure was needed and what recovery would involve. I recommend it — without hiding difficult information.”
Krzysztof M. · ZnanyLekarzRead more — proctology and anal diseases
Diagnostics of anal and colorectal diseases in Gdańsk.
See service →Surgical assessment of complex anal and perineal conditions.
See service →Surgeon and proctologist — profile and appointment availability.
Doctor’s profile →Educational article — in preparation.
Article in preparationBook a proctology consultation in Gdańsk
The doctor will assess the anal area, determine whether this is a fistula and suggest the next steps. Wyspa Medycyny Przyjaznej · Toruńska 15 · Mon–Fri 9:00–20:00.
The information on this page is general and educational in nature and does not replace medical consultation. The diagnosis of an anal fistula, qualification for treatment and choice of method are decided by the doctor after an individual clinical assessment and additional tests. In the event of sudden, severe pain with fever or a rapidly growing abscess around the anus — seek urgent medical help or go to an emergency department.