You need to be operated. No doubt. You can try Conservative approach but will still end up more complicated for surgery. Better to do get operated and wide excision with draining of all collections and lay open of tracts is best. Even if it is problematic for couple of weeks, it is a permanent solution. Done hundreds of such cases and trust me you won't be disappointed.

As an young male it's unusual to find multiple fistulois tracts.. So first rule out any inflammatory diseases of intestine.. Get sigmoidoscopy done first Rule out TB also Now coming to Fistula repair..better get it done as non invasive methods like VAAFT,LIFT ,Plugging of fistulous tract

Clinical examination followed by decision of surgery if needed

Fistula is a blind tract which can get infected and can lead to abscess. So if its long standing it won't heal by itself

MRI report shows new tracts/branches are forming at 5 and 7 ‘o’ clock.

such long standing disease usually wont heal spontaneously now. it is better to get operated. surgery is mostly curative if done adequately. post op care should help you stay disease free

Hello Good Evening.. Dr Mohit Singh this side.. I have got few questions for you What are your Presenting complaints and how is your job profile..i mean is it sedentary or field work Also if there is any associated history of diabetes or any other chronic illness Also give details about bowel habits like complaints of constipation if present?