An anal fistula is commonly known as Fistula-in-ano as it is frequently the result of a previous or current anal abscess. An anal abscess is an infected cavity filled with pus found near the anus or rectum. The fistula is the tunnel that structures under the skin and interfaces the stopped up infected organs to a abscess. A fistula can be available with or without an abscess and may join just to the skin of the buttocks near the anal opening. Microscopic organisms, fecal material or foreign matter can obstruct a butt-centric organ and passage into the tissue around the anul or rectum, where it might then gather in a cavity called an abscess.
Anal Fistula is classified by two categories. 1) By their location in relation to the structures comprising and surrounding the anus and rectum. on this basis, it is subclassified as perianal, ischioanal, intersphincteric and supralevator area. 2) By their relationship to parts of the anal sphincter complex: They are subclassified as intersphincteric, transsphincteric, suprasphincteric and extrasphincteric. Anorectal pain, swelling, perianal cellulitis (redness of the skin) and fever are the most common symptoms of an abscess. Occasionally, rectal bleeding or urinary symptoms, such as trouble initiating a urinary stream or painful urination, may be present.
The surgery may be performed in the meantime as waste of a abscess, once in a while the fistula doesn't show up until weeks or years after the starting drainage. Fibrin glue injection is one such alternative, in which fibrin glue is infused into the fistula tract to decimate the tract with the expectation of getting to be joined in the encompassing tissue. An endoanal advancement flap is a strategy generally held for complex fistulas or for patients with an expanded potential danger for affliction incontinence from a conventional fistulotomy. Another non-sphincter dividing treatment for anal fistula is the LIFT (ligation of the intersphincteric fistula tract) strategy.
Fistula-in-ano is a common condition. It has an incidence of 5.6 per 100?000 in women and 12.3 per 100?000 in men. This disorder is reported to occur predominantly during the third and fourth decades of life; most cases are of cryptoglandular origin. Cohort studies involving 408 patients (AFP = 167, MAF = 241) were included in the meta-analysis. The differences in the overall success rates and incidence of fistula recurrence were not statistically significant between the AFP and MAF [risk difference (RD) = -0.12, 95%CI: -0.39 - 0.14; RD = 0.13; 95%CI: -0.18 - 0.43, respectively]. However, for the AFP, the risk of postoperative impaired continence was lower (RD = -0.08, 95%CI: -0.15 - -0.02) as was the incidence of other complications (RD = -0.06, 95%CI: -0.11 - -0.00).