ANAL FISTULA SURGERY NYC
AWARD-WINNING, NATIONALLY TRUSTED ANAL FISTULA SURGEON
An anal fistula is an infected tunnel that develops between the muscular gland opening at the end of the anal canal and the skin near the anus. Symptoms include discharge and skin irritation, along with a hardened tract leading towards the anal opening. Visit our NYC office or give us a call to learn more about how we can help treat anal fistulas.
WHAT ARE ANAL FISTULAS?
An anal fistula is an abnormal tunnel-like connection between the inner lining of the anal canal and the skin around the anus. It typically forms as a result of an infection or an abscess in the anal glands that doesn’t heal properly. These fistulas can cause discomfort, irritation, and recurring infections, often leading to symptoms like pain, swelling, bleeding, or discharge around the anus.
ANAL FISTULA TREATMENT
NON-SURGICAL ANAL FISTULA TREATMENT
Anal pathology takes time to heal. You can imagine that every time it is attempting to improve, another local trauma/bowel movement occurs. Do not try to avoid having bowel movements, and try not to get frustrated as you work on the above regimen.
- The appropriate initial regimen to treat an anal abscess/fistula consists of:
- Over-the-counter stool softeners, such as Colace, three times daily
- Over-the-counter fiber supplements, such as Metamucil
- Sitz baths utilizing over-the-counter Epsom salts
- Boosting your fiber intake with choices such as grains and whole-grain products, fruits, vegetables, legumes, nuts, and seeds
- Increasing your overall water intake to 8-12 ten-ounce glasses per day
- Refraining from caffeinated beverages, as they tend to cause dehydration
- Keeping the anal area clean and dry. Wash gently with warm, soapy water, and pat dry. Also, consider using something like an isotonic douching solution.
- Limiting the use of toilet paper, as wiping causes local inflammation. Please refrain from using baby wipes or medicated pads.
- Antibiotics for most anal abscesses, and sometimes for fistulas, due to local inflammation.
ANAL FISTULA SURGERY
- Most anal abscesses require in-office drainage. Sometimes, this may require monitored anesthesia care in an ambulatory setting. It is noted to be a 50% chance of complete eradication of the abscess after drainage and a 50% chance of development of an anal fistula. Strategic drainage of the abscess by professionals allows for improved location of fistula formation if this does occur. Generally speaking, anal fistulas must be treated surgically and are characterized as either simple or complex.
- The vast majority of simple fistulas are treated with a fistulotomy, which involves cutting open the fistula in order for the tract to close. For complex fistulas, a technique commonly practiced involves ligation of the internal fistula tract (LIFT procedure) and removal of the remaining tract. If an abscess and tract is still present during the initial operative evaluation, a seton drain may be placed to allow maturation of this tract, followed by the LIFT procedure mentioned above or the use of a cutting seton that is tightened in the office (pulling through the muscle, instead of transecting the muscle in the operating room, super important for our community since it is imperative to keep as much muscle in the game as possible.) Other anal abscesses and fistula surgical options are surgical glue and placing an anal fistula plug in the fistula tract, but these do have limited success.
- We offer anal fistula surgery at our New York City location. To schedule your consultation, contact us today.
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AFTER FISTULA SURGERY
General Recovery After Anal Surgery
Depending on what surgical correction is implemented will determine the specific recovery. However, anal surgery, in general, is all similar in terms of timing. Usually, there is immediate constant pain and irritation in the first 2-3 days, followed by annoyances that happen more so during defecation. You may notice a small amount of blood draining from the opening of your fistula or pus discharge after fistula surgery. This is normal. You can put a gauze pad over the opening of the fistula to absorb the drainage if needed. This can last for 1-2 weeks.
Finally, any anal work usually lasts for 6-8 weeks before one is fully recovered. As for bottoming or anal play, this will start roughly two months after surgery. After three months, you’ll be able to have anal sex after fistula surgery.
Recovery Based on Type of Fistulas
Now, just like we broke down the treatment by simple or complex fistulas, the recovery is similar. For simple fistulas, the procedure is just opening the fistula tract, which is now an open wound or similar to a fissure. This requires one to keep the area super clean and use the appropriate suppositories and lotions provided by the pharmacy for healing. Utilizing a bidet can also be supremely helpful in advancing the fistula and fistulotomy recovery process. During one’s subsequent office visits, we will place some chemicals to complete the healing process. It is not uncommon to drain some mucus or discharge until one sees us four weeks post-surgery. After the second (2-month) post-operative visit, a full internal evaluation is performed, and if there are no issues, anal play with dilators will be initiated.
As for complex fistulas, this depends on what is performed and achieved. The ligation procedure is similar to that of simple fistulas and should be mirrored. The only deviation is if a drain, called a seton, is placed. This is done specifically if it is complex, with either an abscess still present or some technical reason to approach this in a two-stage procedure. Specifically, in our gay community, it is done to spare any negative consequences of a procedure not warranted by others. With that said, it is a strategic placement to let everything settle down, allowing a staged procedure to set you up for success. Remember: we need all the muscle we can get, specifically in the bottoming world. It is imperative one sees someone who has the knowledge to support all comers.
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NEW YORK
44 East 12th Street, Suite MD1
New York, NY 10003
Phone: (212) 206-1501
Email: info@bespokesurgical.com
Bespoke Surgical is located in Manhattan, in the Greenwich Village neighborhood, and easily accessible by car or public transportation.
For patients with questions outside of normal business hours regarding post-surgical care, trying anal play, or irregular bowel movements, please reference our after-hours support guide for more information. Those patients who feel as though they’re having a more serious medical emergency should immediately call 911.
What are anal fistula symptoms?
Anal fistula symptoms often include pain, swelling, or irritation around the anus. You might notice pus or blood discharge from a small opening near the anus, as well as discomfort during bowel movements. In some cases, recurrent infections or abscesses may develop.
How long is anal fistula surgery?
Anal fistula surgery typically lasts between 30 minutes to an hour, depending on the complexity of the fistula. The procedure is often done under general or local anesthesia and may involve techniques like fistulotomy or seton placement. Your surgeon will choose the approach that minimizes risks and promotes effective healing. Most patients can go home the same day after outpatient surgery.
What is the anal fistula surgery recovery process?
Full recovery from anal fistula surgery generally takes three months. Expect some mild pain, swelling, or discharge initially, which can be managed with prescribed medications and sitz baths. Keeping the area clean and following post-surgical care instructions are crucial for healing.
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