When a tunnel develops between the anus and the skin around it, the condition is called anal fistula or fistula in ano. This happens when an infection that starts in the anal gland does not heal properly or fully. When the infection ends in an abscess that drains through the skin around the anus, it leads to the formation of a tunnel under the skin to connect to the infected gland. The only way to treat an anal fistula is through surgery.
Anal fistulas usually do not heal by themselves and surgery is needed to correct the condition. There are multiple effective surgical procedures available and the right one for the patient will be decided based upon the depth of the fistula. Severing the sphincter muscles is not feasible in deeper fistula as it will lead to incontinence. Contamination of the tract through the internal opening does not allow it to heal even for years. Identifying the internal opening and control the contamination is the key to prevent a recurrence. MRI scan or endo-anal ultrasound scan can be required to get the map of the tract.
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