Usually, surgery is necessary to treat an anal fistula by itself as very few heals.
The best option for you will depend on the position of your fistula and whether it is a single channel or branches off in various directions.
Sometimes you may need to have an initial examination of the area under general anesthetic (where you are asleep) to help determine the best treatment.
Anal fistula surgery is usually performed under general anesthetic. In many cases, staying overnight in a hospital is not necessary.
A fistulotomy is the most common type of anal fistula surgery. This involves cutting along the entire length of the fistula to open it up so it heals as a flat scar.
If your fistula passes through the anal sphincter muscles and having a fistulotomy carries a high risk of incontinence, an advancement flap procedure may be considered.
Another option in cases where a fistulotomy carries a high risk of incontinence is the insertion of a bioprosthetic plug.
The ligation of the intersphincteric fistula tract (LIFT) procedure is a relatively new treatment for anal fistulas.
It is designed as a treatment for fistulas that pass through the anal sphincter muscles, where a fistulotomy would be too risky.
The goal of the surgery is to heal the fistula while avoiding damage to the muscles of the sphincter, the ring of muscles that open and close the anus, which could potentially lead to loss of bowel control bowel incontinence.