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Intersphincteric Fistula in ano
Respected Doctors , Proctologists,
Need advice , guidance:
Issue: Intersphincteric Fistula in ano : Posterior Low
Fistulotomy without Laser is adviced.
However , now a days many Laser procedure are there.
Why non laser treatment ?
So many laser procedures are advertised heavily like FILAC , VAAFT+FILAC , EFLA Laser procdure , etc etc
Main point : sphincter- sparing .
Please guide how do i go about to choose.
Thank you very much 🙏🏻🤝🏻
Answers (6)
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Go for open surgery ,it is indicated in low & simple fistula.
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Follow the Doctors advice
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Should be needing surgery
And the method depends completely on the situation so get a consult from a general surgeon
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It’s simple fistula in ano and laser treatment is for complex fistula in ano for any simple fistula treatment surgery is best choice for management so your doctor advise fistulotomy without laser but you can go for laser treatment also
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Laser treatment is preferred in non complicated fistula with patent tract.
Providing MR fistulogram report would be beneficial for advising
Next Steps
Consult a General Surgeon.
Health Tips
Consume soft ,high fibre diet, stool softners.
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Success Rate vs. Recurrence
For a low intersphincteric fistula, a traditional fistulotomy is the 'gold standard.' It has a success rate of nearly 95–100%. Laser procedures (like FiLaC), while modern, have significantly higher recurrence rates (the fistula coming back) for this specific type of track.
2. Minimal Sphincter Involvement
Because your fistula is 'low,' it involves only a very small, safe portion of the internal sphincter. Opening this track surgically provides a permanent cure with a negligible risk to your continence.
3. Why Laser Isn't Always Better
Laser treatments are typically reserved for high or complex fistulas where a traditional cut would involve too much muscle. In your case, using a laser would be less effective and increase the chance that you would need a second surgery later.
Summary
The goal is to cure the fistula the first time. A fistulotomy offers you the highest clinical certainty of a permanent cure with minimal risk to your muscle function."
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So for your query a simple answer is any fistula surgery can be done but specially for LASER aided treatment , it's needed to be a patent fistula tract with internal and external opening. If internal opening is closed with granulation tissue or epithelialization Or there is associated abscess then LASER treatment till now contraindicated.
Next Steps
Know your diagnosis properly. If it's a non complicated fistula as you mentioned then ask your hospital about the availability of LASER machines.
Health Tips
Remember outcomes of all the surgical procedures for Fistula in ano are nearly similar.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.