Treatment of Anal Fistulas
An anal fistula is an abnormal channel connecting the inside of the anal canal or rectum with the skin around the anus, most commonly developing as a complication of a perianal abscess. It requires procedural treatment. At Wyspa Medycyny Przyjaznej in Gdańsk, our proctologists offer both laser treatment using a 1470 nm laser and conventional surgical techniques. The method is selected according to the location, type and extent of the fistula assessed during the consultation.
Reception: Mon–Fri, 9:00 a.m.–5:00 p.m. Gdańsk, 15 Toruńska Street. Price: Needs Data — check the price list or call us.
| Methods | 1470 nm laser, fistulotomy, seton, biological methods |
| Anaesthesia | local or general — depending on the method |
| Initial diagnosis | consultation, anoscopy or rectoscopy |
| Hospitalisation | depends on the method and extent of the procedure |
| Recovery | usually shorter after laser treatment |
| Price | Needs Data — call us or check the price list |
Sara Godyńska, Justyna Szul and Kamil Smok
minimally invasive closure of the fistula tract using a laser fibre
anoscopy, rectoscopy and proctological assessment before treatment
the type and location of the fistula determine the surgical technique
What is an anal fistula?
An anal fistula, also known as fistula ani, is an abnormal channel connecting a glandular crypt in the anal canal with the skin around the anus. It most commonly develops as a complication of a perianal abscess. After spontaneous or surgical drainage of the abscess, the tract may fail to heal completely and may remain as a permanent connection. An anal fistula does not heal on its own and requires procedural treatment. The choice of method depends on its location, type and relationship to the anal sphincter muscles. A detailed assessment is performed by a proctologist during a proctology consultation.
Methods of treating an anal fistula
Laser treatment of an anal fistula — 1470 nm laser
Laser treatment using a 1470 nm wavelength involves inserting a laser fibre into the fistula tract and thermally closing its walls from the inside. The method does not require extensive tissue incisions and may be performed on an outpatient basis, which may result in a shorter healing period compared with conventional surgery. Laser treatment is considered mainly for simple fistulas and selected complex fistulas. The proctologist determines whether it is appropriate after evaluating the clinical findings.
Surgical treatment of an anal fistula — fistulotomy and seton
Surgical techniques are used for fistulas requiring a wider intervention or involving the sphincter muscles. Fistulotomy involves opening and excising the fistula tract. It is effective for low fistulas located below the sphincter muscles. A seton, or drainage thread, is used for transsphincteric or suprasphincteric fistulas. The thread may be gradually tightened or used for drainage, helping to reduce the risk of sphincter damage. The extent and technique of the procedure are selected individually by the colorectal surgeon.
Biological and combined methods
In selected cases, particularly complex or recurrent fistulas, biological methods may be considered. These include filling the tract with tissue or fibrin glue or using a collagen matrix plug. These methods may be used alone or combined with laser treatment or surgical techniques. They require individual assessment and are not suitable for every type of fistula.
Diagnosis before treatment
A proctology consultation is essential before the procedure. The doctor examines the anal area, takes a medical history concerning the symptoms and course of the condition and, if necessary, recommends imaging tests, anoscopy or rectoscopy. These examinations help precisely determine the location of the internal and external fistula openings and their relationship to the sphincter complex.
Recovery
The time required to return to normal activities depends on the method selected. Healing after laser treatment is usually faster than after conventional surgery, and follow-up appointments help assess closure of the tract. After fistulotomy or seton placement, healing may take from several weeks to several months. Careful hygiene of the anal area, a fibre-rich diet and regular follow-up appointments are essential in every case. The patient receives detailed instructions from the doctor after the procedure.
Risks, complications and when to contact a doctor
Treatment of an anal fistula carries a risk of complications, which varies according to the treatment method and the anatomy of the fistula. The doctor discusses these risks individually before the procedure.
This is the most important risk associated with fistula surgery. Fistulas passing through the sphincter muscles require careful planning. Damage may lead to problems controlling wind or bowel movements. Discuss this risk with the doctor before choosing a method.
A fistula may recur after any treatment method, particularly in complex fistulas or in patients with Crohn’s disease. Follow-up appointments are essential.
The wound after fistula surgery is susceptible to infection. Careful hygiene and compliance with the doctor’s instructions significantly reduce this risk.
Laser treatment may not close the fistula after a single procedure. In some cases, the procedure must be repeated or a different method used. The doctor evaluates the result during follow-up appointments.
A fever above 38°C, increasing pain around the anus, pus-like discharge from the wound or swelling after the procedure require urgent contact with the doctor. If you experience difficulty controlling wind or bowel movements, inform the proctologist during the follow-up appointment. Do not delay reporting this symptom, as earlier information gives the doctor more options for possible intervention.
Proctologists — Wyspa Medycyny Przyjaznej, Gdańsk
A proctologist diagnosing and treating conditions affecting the anus and rectum, including anal fistulas and perianal abscesses.
A proctologist experienced in the procedural treatment of proctological conditions, including fistulas, haemorrhoids and abscesses.
A proctologist performing proctological surgical procedures, including treatment of fistulas, haemorrhoids and rectal conditions.
Book a proctology consultation in Gdańsk
Sara Godyńska · Justyna Szul · Kamil Smok
Gdańsk, 15 Toruńska Street · Mon–Fri, 9:00 a.m.–5:00 p.m.
Frequently asked questions — anal fistula treatment
How does laser treatment differ from surgical treatment?
Laser treatment using a 1470 nm laser thermally closes the fistula tract from the inside using a laser fibre. It does not require large incisions, which means less tissue trauma and usually a shorter healing period. Conventional surgery, including fistulotomy and seton placement, is necessary for complex fistulas passing through the sphincter muscles or when laser treatment is insufficient. The choice depends on the fistula anatomy and is made by the proctologist after an examination.
What risks are associated with anal fistula treatment?
The most important risk associated with fistula surgery is possible damage to the anal sphincter muscles, which may lead to problems controlling wind or bowel movements. The risk is higher in complex fistulas passing high through the sphincter muscles. Other complications include recurrence, wound infection and, after laser treatment, incomplete closure requiring another procedure. The doctor discusses the individual risks before treatment is selected.
Can an anal fistula heal on its own?
An anal fistula does not heal on its own. Without procedural treatment, the tract remains open and may cause recurring discharge, pain and infection. A fistula usually results from a chronic infection of an anal gland and requires surgical or laser intervention to close the tract permanently.
How long does recovery take after laser treatment?
Healing after laser treatment is usually faster than after conventional surgery, and many patients return to normal activities sooner than after fistulotomy. Complete closure of the fistula tract is assessed during follow-up appointments. The precise healing time depends on the complexity and location of the fistula and the patient’s individual response. The doctor discusses this after the procedure.
Can an anal fistula recur after treatment?
Recurrence is possible after every treatment method, particularly in complex, branching or recurrent fistulas, including those associated with Crohn’s disease. Regular follow-up appointments allow recurrence to be detected early and further treatment to be planned. Compliance with hygiene and dietary instructions during healing is also essential.
Proctology — related services and diagnostic tests
The most common cause of a fistula — diagnosis and treatment of the abscess.
Details →Qualification for treatment and assessment of the extent of the fistula.
Details →Endoscopic examination of the anus to assess the internal opening of the fistula.
Details →Another common proctological condition requiring assessment and treatment.
Details →Information about symptoms and diagnosis — what a fistula is and when to see a doctor.
Details →Anal fistula treatment — Gdańsk
Sara Godyńska · Justyna Szul · Kamil Smok
Gdańsk, 15 Toruńska Street · Mon–Fri, 9:00 a.m.–5:00 p.m. · tel. +48 600 006 913
The information on this page is intended for general educational purposes and does not replace a medical consultation. The method of treating an anal fistula — laser, surgical or biological — is selected individually by the proctologist after assessing the type, location and extent of the fistula. Every method carries a risk of complications, including a possible effect on sphincter function, which the doctor discusses before the procedure. Fever, increasing pain or pus-like discharge after treatment require urgent contact with the doctor. Wyspa Medycyny Przyjaznej, 15 Toruńska Street, unit AU1, Gdańsk. Tel.: +48 600 006 913.
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