Study record managers: refer to the Data Element Definitions if submitting registration or results information. Anal fistula is the chronic phase of anorectal infection is characterized by chronic purulent drainage or cyclic pain associated with acute relapse of the abscess followed by intermittent spontaneous decompression. Perianal fistulas have a troublesome pathology. The most widely accepted theory is that anal abscess is caused by infection of an anal crypt gland. Suppuration moves from the anal gland to the inter-sphincteric space, forming an abscess leading to the development of a fistula.

Back to Anal fistula. Surgery is usually necessary to treat an anal fistula as they usually do not heal by themselves. There are several different procedures. The best option for you will depend on the position of your fistula and whether it's a single channel or branches off in different directions. Sometimes you may need to have an initial examination of the area under general anaesthetic where you're asleep to help determine the best treatment. The surgeon will talk to you about the options available and which one they feel is the most suitable for you. Surgery for an anal fistula is usually carried out under general anaesthetic.

Like other muscles, your anal sphincter is only accustomed to stretching so far. Your anus is full of sensitive nerve endings that make anal play feel oh so good. Anal training can make anal penetration of any kind pleasurable. It can also help you work up to larger anal toys and other butt play, like gaping. This makes it more prone to tearing and infection, including sexually transmitted infections STIs.

Anal fistula repair still remains challenging. One major reason for surgical failure is a persistent fistula track or remnants of the fistula epithelium which could not be removed during surgery. In a pilot study, we operated on 11 patients with cryptoglandular anal fistula. All patients underwent previous surgery up to 6 times prior to definitive surgery.