Fistula of the rectum

A pararectal fistula is an abnormal channel that forms between the rectum and the skin around the anus. This is a chronic condition that often develops after infections or inflammatory processes in this area. The main cause is an infection that leads to the formation of an abscess (a purulent inflammation) in the tissues surrounding the rectum. If the abscess does not drain naturally, the infection may result in the formation of a fistula, connecting the inner part of the rectum with the skin.

Inflammatory processes contributing to this condition can be caused by diseases such as anal fissures, chronic constipation, infections, Crohn’s disease, or rectal cancer. Trauma from surgeries or anatomical tissue abnormalities can also lead to the development of the disease.

This pathology is classified based on several factors: the location of the exit, localization, and stage of development.

By exit location:

1. Incomplete fistula – has only one opening on the skin or mucous membrane.
2. Complete fistula – the channel forms in the walls of the rectum and sphincter area, having two openings.
3. Internal fistula – both openings are located within the rectal walls.

By localization:

1. Extrasphincteric pararectal fistula – originates from the rectal muscle layer and exits in the perineal area.
2. Intersphincteric – the pathological tract runs under the sphincter.
3. Transsphincteric – passes through the rectal muscles and sphincter.

By stage of development:

1. First stage – a narrow opening forms in the rectal tissues.
2. Second stage – inflammation develops in the fatty tissue, and scar tissue begins to form.
3. Third stage – inflammation progresses, and pus accumulates.
4. Fourth stage – purulent destruction of the tissue occurs, the exit opening expands, and scar tissue formation worsens.

Timely medical consultation can help prevent complications and relapses.

The symptoms of a pararectal fistula vary depending on the type, stage of the disease, and individual characteristics of the patient. The condition may worsen during flare-ups or subside during remission. The main symptoms include:

• Discomfort in the anal area – burning, itching, pain, and a sensation of a foreign body.
• Discharge from the anus – serous fluid, blood-tinged secretions, pus, or fecal matter.
• Swelling and redness around the anus – inflammation of the tissues.
• Difficulty with bowel movements – the process becomes painful and complicated due to impaired sphincter function.

At the first signs of this condition, it is crucial to consult a proctologist to avoid serious health consequences.

An anal fistula can lead to several severe complications if left untreated:

• Infections – the disease becomes chronic, increasing the risk of bacterial infections, tissue inflammation, and abscess formation.
• Purulent complications – as the disease progresses, purulent cysts and abscesses may develop, requiring surgical removal.
• Defecation problems – a pararectal fistula disrupts the normal function of the sphincter, making defecation painful and difficult. This can lead to chronic constipation or incontinence.
• Tissue destruction – prolonged inflammation and infection damage the rectal tissues and surrounding structures, complicating treatment and necessitating surgery.

Timely medical intervention helps prevent serious consequences and complications.

Treatment of a fistula always requires surgical intervention, as the pathological tract must be removed to prevent recurrent inflammation. The process begins with diagnostics, including a patient interview, visual examination, anoscopy, rectoscopy, ultrasound, CT, and MRI. Once an accurate diagnosis is established, a treatment plan is selected.

If an active inflammatory process is present, immediate surgery is not possible. Initially, abscess drainage is performed, and conservative treatment with antibiotics and anti-inflammatory drugs is prescribed. Only after stabilizing the patient’s condition can surgical removal of the fistula be carried out. Surgical methods include:

• Fistula excision – the pathological tract is surgically removed, and the inner cavity is closed; a silicone loop or tissue reconstruction may be used.
• Radio wave removal – performed using a radio scalpel, minimizing tissue damage and speeding up healing.
• Laser treatment – the fistula is removed using a laser, reducing bleeding and pain.

Recovery after surgery takes 4–6 weeks, during which patients are advised to maintain hygiene, avoid heavy physical exertion, and follow a fiber-rich diet.

The “New Life” medical center in Kyiv offers comprehensive services for the treatment of fistulas and other proctological conditions. We combine modern treatment methods, the expertise of our doctors, and high-quality service, ensuring an individual approach to each patient.

Our services include:

• Initial examination and diagnostics.
• Prevention and treatment of various diseases.
• Rehabilitation programs.

We also provide aesthetic medicine and plastic surgery services. Our clinic employs highly qualified specialists in surgery, neurology, gynecology, and urology.

We are open 24/7, providing a comfortable and safe environment where every patient receives the best medical care. Appointments are available through our website, phone, or messaging apps (Viber).