An anal fistula is an abnormal tunnel connecting the skin near the anus with the inner lining of the rectum. It is usually the result of an infection near the anus causing a collection of pus, called a perianal abscess. After the pus has been drained away, an abnormal tunnel remains.
Anal fistulas can also be a result of inflammatory conditions such as tuberculosis or inflammatory bowel disease.
Common symptoms of an anal fistula include:
The key finding from an examination is the presence of one or more small holes in the skin near the anus.
An MRI or ultrasound may be performed to confirm the diagnosis.
Surgery is usually recommended as it is the most effective treatment. An anal fistula rarely heals by itself.
The aim of surgery is to disconnect the tunnel. Special care has to be taken not to damage the anal muscles (anal sphincter) as the anal sphincter controls bowel continence.
There are many types of surgical procedures available but the choice depends largely on the type of abnormal tunnel.
Superficial Tunnels- Fistulotomy
The abnormal tunnel is opened up to allow drainage.
Superficial Tunnels- Fistulectomy
The abnormal tunnel is removed.
Deeper or Multiple Tunnels
Insertion of a specialised surgical thread called a seton, or filling the tunnel with a special glue or tying the tunnel (LIFT procedure).
All these procedures have different risks and benefits. However, most of these procedures may be performed as a day surgery procedure. If admission is required, the average length of stay is one night.
Some patients may require multiple operations especially if there are multiple tunnels or if the tunnel is very deep. The fistula can recur despite surgery. There is also a risk of damage to the muscles controlling bowel movement (anal sphincters), and thus risk of faecal incontinence. Fortunately, this is very rare.
Colorectal & General Surgeon
Upper Gastrointestinal, Bariatric & General Surgeon
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Our clinics will be closed from 16 – 18 Feb for CNY
Our clinic at Mt Alvernia Medical Centre A will be relocating from #06-05 to #03-03 (within the same building) on Friday, 26 Sep afternoon.
Our telephone line 6353 4855 will be temporarily unavailable from 12:00pm – 6:00pm on 26 September. During this period, you may reach out to our other clinics for assistance:
We will begin operations at our new premises (#03-03) from Tuesday, 30 Sep onwards.
We look forward to serving you at our new clinic!
Nexus Surgical clinics at Mt Elizabeth Novena Specialist Centre, Gleneagles Medical Centre, Parkway East Medical Centre and Mt Alvernia Medical Centre will be closed on 28 January 2025 for Lunar New Year celebrations, while our clinic at Mt Elizabeth Orchard Medical Centre remains open from 0900-1300 hours on 28 January 2025.
Please leave a message in our voice mails and we will respond to you as soon as we can when we resume our clinics on 31 January 2025. If you require any urgent assistance, kindly go to the Urgent Care Centre of any hospitals or contact your doctor through the Emergency Answering Service. Our team at Nexus Surgical would like to take this opportunity to wish you and your loved ones a Happy & Prosperous Lunar New Year with good health in the Year of the Snake!
Nexus Surgical will be away from 17 to 20 October 2024 for our Annual Company Retreat. The aim of our retreat is to review and to recharge, so that we may serve you better.
Our clinics at Mount Elizabeth Orchard, Mount Elizabeth Novena, Mount Alvernia and Parkway East hospitals will therefore be closed during this period. In the meantime, if you require any urgent assistance, kindly contact us through our Answering Service at +65 6333 5550.
We thank you for your understanding and patience for any inconvenience.
