What is a fistulotomy?

A fistulotomy is a surgical procedure used to treat anal fistulas. It involves opening up the fistula tract so that it can heal from the inside out. This is often the simplest and most effective treatment for fistulas that are not too deep or complex

The procedure is usually performed under general anaesthetic and is considered one of the most effective ways to cure an anal fistula

Why might you need a fistulotomy?

A fistula is an abnormal tunnel between the anal canal and the skin around the anus. It can cause:

• Recurrent abscesses and infections

• Pain and discomfort around the anus

• Pus or fluid leaking from an opening near the anus

• Irritation or swelling in the anal area

A fistulotomy removes the infected tract, helping the area heal and preventing further infections.

How does a fistulotomy work?

• The surgeon identifies the fistula tract

• The tract is then cut open and flattened to allow healing

• Any infected tissue is removed

• The wound is left open to heal naturally over several weeks

The procedure usually takes 30 to 60 minutes and is performed as a day case, meaning you can go home the same day.

What happens after the procedure?

• You may have some pain and swelling after the surgery

• Pain relief and stool softeners may be recommended to help with bowel movements

• You should avoid straining, heavy lifting, and strenuous activities for a few weeks

• Most people return to normal activities within a few days but complete healing may take several weeks

How do you care for the area after surgery?

• Keep the area clean and dry to prevent infection

• Wash gently with warm water after bowel movements

• Avoid using scented soaps or wipes that may irritate the skin

• Wear a pad or soft tissue to absorb any minor leakage

• Take stool softeners if needed to reduce discomfort

If you experience increased pain, swelling, or signs of infection, contact your doctor.

How successful is a fistulotomy?

A fistulotomy is highly effective for treating simple fistulas, with a high cure rate. However, healing can take a few weeks and, in rare cases, the fistula may return.

For more complex fistulas, other treatments such as a seton drain, LIFT procedure, or advancement flap may be needed.

Are there any risks?

A fistulotomy is a safe and effective procedure, but as with any surgery, there are some risks:

• Mild discomfort or swelling around the surgical site

• Infection, which is rare if proper hygiene is maintained

• Minor bleeding, which usually settles on its own

• Scarring, which is usually minimal

• Risk of incontinence – If the fistula is deep or passes through the anal sphincter muscles, the risk is slightly higher. Your surgeon will assess this before recommending the procedure

If you experience severe pain, fever, or excessive bleeding, seek medical advice.

Why choose the Midlands Bowel Clinic?

• Expert colorectal surgeons with extensive experience in fistula treatments

• Advanced diagnostic tools, including MRI and endoanal ultrasound for precise assessment

• Personalised treatment plans tailored to your condition

• Comprehensive aftercare and follow-up support to ensure the best outcome

Contact us

If you have an anal fistula and need advice on fistulotomy treatment, contact the Midlands Bowel Clinic. We are here to help.