What are a fistula plug and fistula paste?

Fistula plug and fistula paste treatments are minimally invasive options for managing anal fistulas. This technique involves inserting a collagen plug or injecting collagen paste into the fistula tract to help it heal.

Who is this treatment suitable for?

• This method is not suitable for all fistulas

• The inner opening of the fistula needs to be closed with stitches

• Patients usually need a seton drain for at least 6 weeks before the procedure

• Fistula plugs and paste have a higher risk of failure or recurrence compared to other surgical treatments

What does the operation involve?

• The procedure is done under general anaesthetic as a day case

• No special bowel preparation is usually needed\

• Surgery takes around 45 minutes

Steps of the procedure:

• The surgeon examines the fistula tract and removes any seton drain

• The fistula is thoroughly cleaned to prepare it for the plug or paste

• The collagen plug is inserted or the paste is injected into the fistula tract

• The inner opening of the fistula is closed with stitches

• The outer opening is left open to allow for natural drainage

• A simple dressing is applied

What are the risks?

All surgeries come with small risks. Before your operation, a pre-operative assessment will check for heart or lung conditions and other medical concerns.

• Blood clots (thrombosis) – You may need to wear compression stockings, and if staying overnight, blood-thinning injections may be given

• Bleeding – Some patients notice a small amount of blood from the wound, which is normal

• Ongoing discharge – You may have some discharge from the wound until it fully heals

• Pain or swelling – If you experience increasing pain, redness, or swelling, contact the clinic or your GP

What happens after the operation?

• Most patients find this procedure not too uncomfortable

• You will be given a stool softener to help keep your bowels moving without straining

• It may feel uncomfortable at first, but keeping your bowels regular is important

• You will have a follow-up appointment to check healing progress

• If your wound needs ongoing care, we may ask your GP practice nurse to help with dressings

For more advice on looking after your bottom after surgery, please refer to our aftercare guide.

Why choose the Midlands Bowel Clinic?

• Specialist colorectal surgeons with extensive experience in fistula treatments

• Minimally invasive options for faster recovery

• Personalised care and aftercare support

Contact us

If you have an anal fistula and need advice on fistula plug or paste, please contact the Midlands Bowel Clinic. We are here to help.