Anal Fistula Treatment in Singapore

Passes through the internal sphincter, exiting near the anus. It is the most common type and more straightforward to treat surgically.

Crosses through the internal and external sphincter muscles before reaching the skin. Their treatment requires careful consideration of sphincter muscle preservation to maintain proper bowel control.

Travels above the anal sphincter structure before crossing back down to the skin. They follow a more complex path and often require specialised surgical techniques.

Bypasses sphincter muscles entirely, connecting directly to the rectum or anal canal. They are rare and often associated with underlying conditions such as Crohn’s disease or rectal cancer, presenting considerable challenges in treatment.

Antibiotics

These medications help treat active infections and reduce inflammation. A typical course lasts 7–14 days. While antibiotics alone do not heal fistulas, they can temporarily control symptoms.

Fibrin Glue

The surgeon injects a specialised glue into the cleaned fistula tract to close it. This minimally invasive procedure, performed under local anaesthesia, typically takes about 30 minutes. While success rates vary, it is an effective option for preserving sphincter function.

Fistulotomy

This technique involves opening the entire fistula tract. The surgeon cuts along the length of the fistula, removes infected tissue, and allows the wound to heal from the inside out. This method works best for simple, low fistulas that involve minimal sphincter muscle.

Seton Placement

A soft surgical thread (seton) is placed within the fistula and secured on the skin surface outside the anus. This technique facilitates drainage, reduces infection, and allows the fistula to heal gradually while minimising damage to surrounding tissue. The process typically takes several weeks and is particularly useful for preserving sphincter function in more complex cases.

LIFT (Ligation of Intersphincteric Fistula Tract)

This technique involves tying off and removing the fistula tract while preserving the sphincter muscles. This technique preserves the anal sphincter muscles and reduces healing time compared to traditional methods.

Rectal Advancement Flap

The surgeon creates a flap of healthy tissue from the rectum or anal canal. After removing the internal opening of a fistula, the flap is pulled down to cover the repair site. This method suits complex fistulas and helps maintain muscle integrity.

Video Assisted Anal Fistula Treatment (VAAFT)

VAAFT is a modern and advanced minimally invasive approach for managing complex anal fistulas. This technique uses a video scope to visually examine the entire fistula tract, from the external opening to its internal origin. Once the internal opening is located, it is sealed, and the fistula tract is thoroughly cleaned with specialised tools, such as a brush and probe, under direct visualisation. One of the key advantages of VAAFT is that it eliminates the need for a large incision on the skin, resulting in a less invasive procedure and potentially quicker recovery.