Anal Fistula Repair in Sharjah
Medically reviewed by Dar Al Kamal Team
What is anal fistula repair?
Anal fistula repair is an operation that closes or opens up an abnormal channel, called a fistula, between the lining of the anal canal and the skin around the anus. The channel usually has an inner opening inside the canal and an outer opening on the skin, where a small spot keeps leaking fluid, blood or pus and may flare into a painful swelling from time to time.
Most anal fistulas begin with an anal abscess. After the abscess drains, the track the infection made can stay open and line itself with tissue, and that lining is why a fistula keeps discharging. Treatment of the abscess itself is covered on the anorectal abscess treatment page.
The key to fistula surgery is the ring of muscle around the anus, the sphincter, which controls wind and stool. Every fistula passes through or around part of this muscle, and the technique is chosen according to how much muscle the tunnel crosses. At Dar Al Kamal Hospital, Sharjah, anal fistula repair is performed by the general surgical team as part of its colorectal surgery service.
Who needs it
Anal fistula repair is for people with a persistent opening near the anus that leaks, stains underwear, itches, or keeps forming a tender lump that bursts and settles again. Many have had an abscess drained in the past. A fistula rarely closes by itself, so surgery is the usual treatment once one is confirmed.
The surgeon first maps the fistula. Some are simple and shallow, crossing only a small amount of muscle. Others, called complex fistulas, run higher, branch, or cross a larger part of the sphincter. An MRI scan of the pelvis or an ultrasound examination inside the anal canal may be arranged to show the exact path. Conditions such as Crohn's disease can also cause fistulas, and these may need a gastroenterology opinion alongside surgery.
The choice of technique depends on this map, on your bowel control today, on any previous anal operations, and for women on previous childbirth, which can affect the muscle. Your surgeon explains why a particular option suits your fistula.
What happens
Anal fistula repair is usually done under general anaesthesia or a spinal anaesthetic, and most people go home the same day. With you asleep, the surgeon gently passes a fine probe along the tunnel to confirm its course and find the inner opening. The main techniques used at Dar Al Kamal Hospital are these:
- Fistulotomy. For a low fistula that crosses little muscle, the surgeon opens the tunnel along its length and lays it flat, so it heals from the base as a shallow groove.
- Seton. A seton is a soft thread or thin band passed through the tunnel and tied loosely in a loop. A draining seton keeps the channel open so infection can escape and the area can settle; some setons are tightened in stages. A seton is often the first step before a definitive repair of a higher fistula.
- Laser. A thin laser fibre is passed into the tunnel and gradually withdrawn, sealing the lining from the inside. Laser treatment leaves the sphincter muscle undivided and suits selected fistulas.
- Doppler-guided techniques. A small ultrasound probe helps the surgeon locate the vessels and structures around the internal opening, so the treatment can be targeted precisely.
Some fistulas need more than one stage. The surgeon tells you before the operation whether a staged plan is likely.
Preparing for it
A pre-operative assessment and any blood tests are arranged before the day. Bring your scan reports and a full list of your medicines; blood thinners and diabetes medicines each need a plan, and you receive fasting instructions for the anaesthetic. Some people are asked to use a small enema on the morning of surgery to empty the lower bowel, and the team explains this if it applies.
Arrange a lift home and bring soft sanitary pads for discharge in the first days. If you would like to plan the operation around Ramadan, travel or a busy period at work, discuss the timing early.
Afterwards
Some soreness and a small amount of discharge are expected while the wound heals, and a pad keeps clothing clean. Warm-water rinses after each bowel movement ease discomfort and keep the area clean. Soft stools help: drink plenty of water, especially in the Sharjah heat, and eat fibre-rich food.
If you have a seton, the thread stays in place between visits and becomes part of your routine; it is cleaned in the shower like the surrounding skin. Your surgeon reviews you in clinic to check healing and, where a staged plan is in place, to decide on the next step.
Desk work often resumes within days. Jobs with long hours of driving or physical work may need more time, and your surgeon gives you a personal timeline.
Contact the hospital urgently if you develop a fever, increasing pain or swelling, or heavy bleeding from the wound. **Go to the emergency department straight away if you feel very unwell with shaking chills or have difficulty passing urine.**
Cost and insurance
Most UAE insurance plans cover anal fistula repair when it is medically needed, and planned surgery usually requires pre-approval supported by the examination findings and any MRI report. The MRI often needs its own approval. When treatment is staged, each stage may be approved separately. Dar Al Kamal Hospital, Sharjah can help you confirm your cover before surgery on 06 599 7777.
Related services
Frequently asked questions
What are the risks of anal fistula repair?
The risks of anal fistula repair include bleeding, infection, slow healing, a reaction to the anaesthetic, and the fistula coming back. Because the surgery works close to the anal sphincter, there is a risk of reduced control of wind or stool, which is why the technique is matched to how much muscle the fistula crosses. Your surgeon explains the balance for your fistula.
Can an anal fistula heal without surgery?
An anal fistula rarely heals without surgery, because the tunnel develops its own lining that keeps it open. Antibiotics can calm a flare-up of infection, and a fistula caused by Crohn's disease may respond to medical treatment, but most fistulas need a procedure to close.
Is laser fistula treatment better than a fistulotomy?
Laser fistula treatment and fistulotomy suit different fistulas rather than one being better overall. Laser treatment leaves the sphincter muscle undivided, which suits some higher fistulas, while a fistulotomy gives a reliable result for low fistulas that cross little muscle. Your surgeon recommends the option that fits the path of your fistula.
How long does a seton stay in?
A seton stays in for a period your surgeon sets according to its purpose, which can range from weeks to several months. A draining seton may stay until the infection has settled and a definitive repair is planned, and your surgeon reviews it at each clinic visit.
Will anal fistula surgery affect my bowel control?
Anal fistula surgery aims to protect bowel control, and the technique is chosen with that in mind. Operations that divide little or no sphincter muscle carry a lower risk to control. If you already have any leakage, tell your surgeon before the operation, as this influences the choice.
Can an anal fistula come back after repair?
An anal fistula can come back after repair, particularly after techniques that preserve all of the muscle or when the fistula is complex. A recurrence can usually be treated again, and follow-up visits check that the tunnel has closed fully.
Why do I need an MRI before fistula surgery?
An MRI before fistula surgery shows the exact path of the tunnel, any branches and how much sphincter muscle it crosses. This map helps the surgeon choose the safest technique and reduces the chance of missing part of the fistula.
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