Anal Fistula

Anal fistula (or fistula-in-ano) is an abnormal connection between anal canal and perianal skin.

It causes a lot of discomfort for the patient with pain, purulent discharge and anal itching.

Fistula is the result of a perianal abscess. This happens when one gland of the anal canal gets blocked, inflamed and later on becomes purulent. Symptoms of perianal abscess are: intense perianal pain, fever and sometimes purulent discharge from the abscess if it drains spontaneously.

Then the abscess can heal (in most cases antibiotics and surgical drainage are necessary) or unfortunately becomes a perianal fistula.

Perianal fistula is abscess transformation, when the infection find its way from anal canal to perianal skin.

Anal fistula cannot heal by itself, and requires careful surgical treatment because of the delicate anatomy of the anal canal.

In fact, the fistula usually passes through anal sphincters, therefore surgical treatment needs to respect their integrity, in order to preserve patient’s continence. 


Symptoms of anal fistulas:                              

  • Anal and perianal pain, usually worse after a bowel movement 
  • Perianal discomfort
  • Chronic purulent discharge
  • Itching and skin irritation around the anus


How do we treat an anal fistula?

Careful evaluation with a proctological visit completed with anoscopy and endorectal 3D ultrasound, and in complex cases MRI (magnetic resonance), are mandatory in order to study the fistula tract and its relationship with the anal sphincters.


Dr. Valentina is proud to bring from Italy the newst technique in the field!


  • VAAFT (Video Assisted Anal Fistula Treatment) – This is a new technique for treating anal fistula in a real minimally invasive way with nearly no pain and absolutely with no incontinence risk. VAAFT is the only technique that allows to directly see the fistula tracts and cavities with the fistuloscope and treating them under direct visionwith an electrode. The internal orifice can be closed either with a flap or with a stapler. With this technique no seton is used, no painful medications are necessary and there is minimal to no risk of sphincters injury (no incontinence risk).