Anal abscess (Abscessus ani) is an acute condition characterized by pain and swelling in the anal area, commonly with high body temperature. It is formed by spreading of the inflammation of periproctal glands in the anal area, between the internal and external sphincter with the formation of pus-filled cavity.
Spontaneous pus effusion from the abscess brings relief because pain disappears and the temperature is lowered.
Treatment is surgical: under short intravenous anesthesia, the content is evacuated through an incision above the swelling. It brings relief and the pain is immediately gone. With further antibiotic therapy, the patient is already capable to work the next day.
Anal fistula (Fistula ani) is almost exclusively a result of repeated abscess. After a spontaneous evacuation or surgical incision of the abscess, a canal is created that leads from the excretory glandular canal to the skin opening, directly on the spot of the anal crypt. It is mostly painless; occasional spontaneous effusion of muddy yellowish content – pus, is possible, onto the external skin around the anus.
Surgery is necessary in order to treat a fistula.
Fistula surgery is relatively simple if the fistula is shallow and does not pass through the anal sphincter (muscle contractor). If the fistula is long and passes through the sphincter, seton drainage is usually done in order to avoid damage to the sphincter and prevent incontinence (incapability of withholding stool) caused by surgery. The aim of the surgery is to – by gradually tightening the thread – present a fistuous canal outwards (a groove is made from the canal).
If correctly treated, the problem does not usually return. However, in advanced fistulae, due to spreading of the infection and creation of numerous canals, it is sometimes difficult to identify all the canals so relapse is possible after a couple of months or years.
For a definitive and permanent riddance of the fistula problem, the ideal solution is Biolitec laser: radial emission of a laser beam using a flexible probe, FiLaC fiber – Fistula-tract Laser Closture. Laser beam of certain energy is radially emitted across the fistulous canal and destroys its epithelium in a controlled and gentle way; it also aids the further process of healing. Biolitec fotkeFiLaC
Preparation
Act according to instructions previously given by an anesthesiologist: the day before the procedure, after light supper, it is, perhaps, necessary to take a mild laxative in order to ensure morning defecation. In the morning, it is advised to drink 3-5dl of Donat Mg and after that, stop taking liquid and eating. Common therapy, if necessary, take according to standard scheme or according to the arrangement made by anesthesiologist during the preoperative exam.
Recovery
Shortly after the procedure, the patient is, with an escort, discharged home with a recommendation for analgesic therapy during the next 2 days.
After a couple of days, the patient is already capable of work and other activities.
Patient hygienic-dietary regime:
- avoid ‘fast food’, pay attention to fiber intake, with a lot of residue
- intake of minimum 2-2,5 l of fluid daily
- do not postpone defecation
- wash with warm water after defecation
- avoid chemical laxatives
Side effects and complications
As well as with other surgical procedures in this region, bleeding of different volume is possible. But, with correct preparation of the patient and adequately performed technique by an expert surgeon, this complication is negligible.
Package
Package includes: preoperative examination by an anesthesiologist, procedure itself, thromboprophylaxis if necessary, analgesics for 1-2 postoperative days and control examinations during the next 6 months.
