Anal fistulas can be a difficult disorder to treat. One of the problems is that the muscles around the anus, called the “sphincters”, may be damaged. If too much muscle is damaged, then incontinence (inadvertent loss of bowel content) may occur. The standard operation for the treatment of fistulas, called a “fistulotomy”, involves dividing the fistula and the muscle that it runs through. If the fistula runs through too much muscle, then there is a risk of damaging the sphincters and a risk of incontinence.
There have been a number of “sphincter preserving” operations developed. One of these procedures is the “endorectal advancement flap” which has very high success rates in terms of healing the fistula with minimal risk of incontinence as it does not damage as much muscle as a fistulotomy. It involves pulling some healthy tissue down over the inside opening of the fistula to close it off and allow it to heal. Mr Eugene Ong is able to discuss with you the various types of treatments for fistulas and what is most appropriate for you.