An anal fistula is a small tunnel that develops between the skin around your anus and the very end of your back passage (the anal canal). You’ll usually need to have surgery to treat an anal fistula.
General information about Anal Fistula Surgery
The following table describes general information about Anal Fistula Surgery including Anal Fistula Surgery cost in Iran, recovery time, and to name but a few.
Starts from $ 300
Back to Work
1 to 2 Weeks
Duration of Operation
Minimum Stay in Iran
About Iranian Surgery
Iranian surgery is an online medical tourism platform where you can find the best Surgeons to treat your anal fistula in Iran. The price of treating an anal fistula in Iran can vary according to each individual’s case and will be determined by the type of anal fistula treatment you undergo and an in-person assessment with the doctor. So if you are looking for the cost of anal fistula surgery in Iran, you can contact us and get free consultation from Iranian surgery.
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Before Anal Fistula Surgery
Causes of anal fistula
What causes an anal fistula?
The leading causes of an anal fistula are clogged anal glands and anal abscesses. Other, much less common, conditions that can cause an anal fistula include:
. Crohn’s disease (an inflammatory disease of the intestine)
. Radiation (treatment for cancer)
. Sexually transmitted diseases
. Diverticulitis (a disease in which small pouches form in the large intestine and become inflamed).
What are the symptoms of an anal fistula?
The signs and symptoms of an anal fistula include:
. Frequent anal abscesses
. Pain and swelling around the anus
. Bloody or foul-smelling drainage (pus) from an opening around the anus. The pain may decrease after the fistula drains.
. Irritation of the skin around the anus from drainage
. Pain with bowel movements
. Fever, chills and a general feeling of fatigue
You should see your doctor if you notice any of these symptoms.
Diagnosis of anal fistula
Your GP will ask about your symptoms and may examine you. Your GP may be able to see the opening of an anal fistula in the skin around your anus (known as the external opening). They may check for further signs by gently inserting their finger inside your back passage. Your GP may refer you to a colorectal surgeon for further investigation and treatment.
Your surgeon may need to do some additional tests and examinations if the diagnosis isn’t clear, or if you have a complex fistula with multiple tracts.
These may include an ultrasound scan of your anus, using a probe inserted into your back passage, a magnetic resonance imaging (MRI) or a computer tomography (CT) scan. They may also do a more detailed physical examination of your anus under anaesthesia if necessary.
Preparing for anal fistula surgery
Your surgeon will explain how to prepare for your anal fistula surgery. For example, if you smoke, you’ll be asked to stop, as smoking increases your risk of getting a wound or chest infection, and slows wound healing.
Your operation will usually be done under general anaesthesia which means you’ll be asleep during the operation. Some procedures for anal fistula can also be done using regional anaesthesia. This means you’ll be awake during the operation, but the lower part of your body will be numb. After your operation, you’ll usually be able to go home the same day. You’ll need someone who can drive you home and stay with you overnight.
If you’re having a general anaesthetic, you’ll need to stop eating and drinking a few hours before your procedure. Follow your anaesthetist/doctor's advice and if you have any questions, just ask.
On the day of your procedure, your surgeon will meet with you to check you are well and still happy to go ahead. The staff at the hospital will do any final checks and get you ready for surgery. This may include asking you to wear compression stockings, or having an injection of an anticlotting medicine to help prevent deep vein thrombosis (DVT).
Risks and Complications
What are the Risks and Complications of anal fistula surgery?
Complications are when problems occur during or after the operation. The possible complications of any operation include things like infection, bleeding or an unexpected reaction to the anaesthetic. Specific complications of anal fistula operation include the following.
. Losing bowel control. This means you can’t control when you poo or sometimes just when you pass wind. The risk of this happening is different for different types of procedure. When your surgeon assesses you before your surgery, they’ll advise which type of operation is best to minimise the risk of this happening.
. Your wound takes longer than usual to heal.
. The fistula may come back. The chance of this happening varies between different procedures. You may need a different type of operation if it comes back.
. Narrowing (stenosis) of your anal canal – the end of your back passage. This can happen as your fistula starts to heal, and can make it difficult to pass faeces (poo). Your doctor may prescribe medicines to help with this.
Can an anal fistula be prevented?
You can greatly reduce your risk of an anal fissure by avoiding constipation, keeping your stools soft and going to the toilet to open your bowels as soon as you feel the urge to go. To help your bowel work properly and keep your stools soft, it's important to drink lots of fluid and get regular physical exercise.
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During Anal Fistula Surgery
What are the treatments for an anal fistula?
What happens during anal fistula surgery?
An anal fistula will not heal without treatment and there are a range of different treatment options available. The first step is to treat any infection with antibiotic treatment. Anal fistulas then often require surgery. The main treatment options include:
The most common type of operation for simple fistulas is a fistulotomy. This involves opening up the fistula so that it can heal from the inside out. Once your anaesthetic has taken effect, your surgeon will insert a probe into the opening of the fistula. They’ll then cut through the skin and underlying tissues, opening up the top of the fistula. The wound is left open without any stitches so that it can gradually heal. This type of operation works well for the majority of simple fistulas.
Other options for complex fistulas
Occasionally you may need a different type of treatment. This is more likely if your fistula passes through more of your sphincter muscle, you have several fistulas, or if your fistula keeps coming back.
Your surgeon may initially pass a small thread, called a seton, through your fistula before any other procedure. This helps to drain it to prevent infection. Some people just continue to have treatment with setons over the long term, without going on to have any further procedures.
Other types of surgery include the following:
. Staged fistulotomy. This is when you have several operations over a number of months, to open up the fistula a little at a time. A loose seton is placed around the remaining fistula each time until your next operation, to help drain it.
. A cutting seton. This is a specific type of seton that gradually cuts through the sphincter muscle, opening up the fistula and allowing scar tissue to form behind. This reduces the risk of incontinence.
. Anal advancement flaps. This involves creating a ‘flap’ of tissue within your anal canal, which is sewn down over the fistula opening. It avoids your surgeon needing to cut through your sphincter muscle.
. Plugs, glues and pastes. These can be inserted or injected into your fistula to block it and help it to heal. There isn’t much good evidence to show that these work – but they give another option that avoids cutting your sphincter muscle. Your doctor may recommend trying it as part of a research trial.
. LIFT procedure (ligation of the intersphincteric fistula tract). This surgery is for fistulas that pass through the sphincter muscles. It involves closing up one end of the fistula before cutting the fistula open, between your sphincter muscles.
. Endoscopic ablation. This procedure involves using an electrode to burn away tissue inside the fistula, before sealing it up.
. Laser therapy. In this procedure, laser therapy is used to destroy and seal the fistula. There’s limited evidence on how well it works. Not all surgeons provide this, and it can only be done in certain circumstances.
Depending on which procedure you have, you may not need to stay in hospital overnight. Some people, however, need to remain in hospital for a few days after their surgery. The surgery usually takes between a quarter of an hour and half an hour.
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After Anal Fistula Surgery
What to expect afterwards
You’ll need to rest until the effects of the anaesthetic have passed. You’re likely to have some discomfort as the anaesthetic wears off, but you'll be offered pain relief as you need it. If you have any problems passing urine after your surgery, you may need a catheter at first (a tube that drains urine from your bladder).
Once you’re ready, your nurses will encourage you to get up and move around. This will help to prevent complications. You can begin to drink and eat when you feel ready.
You’ll usually be able to go home on the day of your surgery. However, you’ll need someone who can drive you home and stay with you overnight. Having a general anaesthetic can really take it out of you. You might find that you're not so co-ordinated or that it's difficult to think clearly. This should pass within 24 hours. In the meantime, don't drive, drink alcohol, operate machinery or make any important decisions.
Before you go home, you’ll be given some advice about caring for your wounds, signs of infection to look out for and pain relief you can take. You’ll also be told what the arrangements are for follow-up in the clinic.
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Recovering from anal fistula surgery
You’re likely to have some discomfort for the first week or so after having anal fistula surgery. You can take over-the-counter painkillers such as paracetamol or ibuprofen if you need pain relief. Constipation can be common after surgery. Your surgeon may recommend that you take a laxative to soften your stools and help to reduce any discomfort. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Your wound should heal within six weeks. You might find it helpful to use a gauze pad in your underwear to protect your clothes from any discharge from your wound.
Have a bath or shower two or three times a day to help ease pain and discomfort as well as keeping your wound clean. Dry the area carefully afterwards. Don’t add anything to the bath water as this can irritate your wound.
Your surgeon will give you advice about driving, going back to work, having sex and getting back to your usual activities and routine.
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Anal Fistula Surgery cost
The cost of Anal Fistula Surgery in Iran starts from $300, depending on the surgeon fee, Geographical location and the type of treatment.