Intersphincteric Fistula

Intersphincteric anal fistula refers to the development of an abnormal channel between the sphincter muscles located inside and outside the anus. These types of fistulas begin in the inner part of the anal canal and continue between the sphincter muscles, opening to the outside of the anus. Intersphincteric fistulas are the most common type of anal fistula. They often occur as a result of the drainage of anorectal abscesses. Anorectal abscesses are collections of pus caused by infection in the tissues around the anus or rectum. As these abscesses heal, they create a path to the outside with the infected tissue. This then turns into a fistula.

Intersphincteric fistulas generally arise at the end of a pathological process, and their treatment can be simpler compared to other types of fistulas. However, professional medical help is required for proper diagnosis and successful treatment. These fistulas are often treated with minimally invasive procedures. The minimally invasive nature of the treatment procedure ensures a faster and more comfortable recovery process for the patient. It also helps preserve sphincter function.

What are the Symptoms of Intersphincteric Anal Fistula?

The symptoms of intersphincteric anal fistula can vary depending on the area where the fistula formed and its severity. Among the most common symptoms of intersphincteric anal fistula are pain, discomfort, and itching felt in the anal region. Patients may also experience severe pain during defecation and blood traces may be seen in the stool. Bloody or purulent discharges may come from the fistula tract continuously or periodically. This is also among the commonly observed symptoms.

All these symptoms can harm the patient's quality of life and may cause the infection to worsen progressively. Therefore, when encountering these symptoms, it is necessary to immediately consult a healthcare institution for early diagnosis and successful treatment. Early intervention also reduces the likelihood of complications in the treatment of intersphincteric anal fistula.

What Causes Intersphincteric Anal Fistula?

The most fundamental factor in the development of intersphincteric anal fistulas is the development of an infection in the anorectal region. These infections often arise as a result of the blockage of anal glands. The infection leads to the development of an abscess in the anal area. When abscesses are drained, meaning emptied, a fistula tract forms as the infected tissue finds a way to the outside. This process is a result of infection and inflammation. This condition is more commonly observed in individuals with weaker immune systems.

In addition, chronic inflammatory bowel diseases, sexually transmitted diseases, and past trauma and surgical operations can also cause intersphincteric anal fistulas. In each case, correctly identifying the underlying cause of the problem ensures that the treatment is properly planned and implemented. To restore the patient's health, the source of the problem must be accurately determined.

How is Intersphincteric Anal Fistula Treated?

The primary method for treating intersphincteric anal fistula is surgical intervention, as the fistula tract can be successfully closed with surgery. How the treatment process proceeds depends on the fistula's location, size, and severity. The most common surgical treatment procedures are fistulectomy and fistulotomy. The fistulotomy method involves making an incision along the fistula tract and creating a channel to promote healing. In a fistulectomy operation, the fistula tract is completely removed from the body. The operation can be performed while the patient is under general or local anesthesia.

Sometimes, if there is a risk of damage to the sphincter muscles, the seton treatment method may be used. Seton treatment is a type of suturing procedure in which a seton is placed inside the fistula tract to provide infection drainage and support the healing process. With the seton method, the fistula heals slowly, thereby preserving the sphincter muscles.

Non-Surgical Treatment of Intersphincteric Anal Fistula

Non-surgical treatment methods can be preferred for mild cases and are also considered an important alternative for patients who are not suitable for surgical operations. Among the methods used for non-surgical intersphincteric anal fistula treatment are fibrin glues and biological plugs. Fibrin glues are injected into the fistula tract and allow the channel to be closed, thereby promoting the body's natural healing process. Biological plugs are placed inside the fistula tract. These plugs are materials that can be absorbed by the body over time. In these minimally invasive methods, the post-treatment recovery process is faster.

The success of non-surgical treatment methods varies depending on the size of the fistula, its cause, and its characteristics. Non-surgical methods may not be suitable for complex and recurrent fistulas. Your doctor will decide which treatment option is most appropriate for the patient after detailed screening, examination, and tests. When deciding on the treatment method, the patient's preferences, lifestyle, general health status, and subjective conditions should also be taken into consideration.