Our Summary

The study looked at the long-term recurrence of anal abscesses, a common problem requiring emergency treatment, and the occurrence of fistulas (abnormal connections between body parts) after the abscess was drained and cleaned. Researchers followed up with 303 patients who had abscesses of a certain type, checking in after two months, a year, and five years. They recorded any previous anal issues, abscess details, recurrence timing and type, symptoms at the first check-up, and presence of fistulas, found either through a physical check or ultrasound.

The results showed that over an average of about 10 years, almost half of the patients had their abscess come back. Most of these recurrences happened in the first year. They also found fistulas in 70% of patients who had symptoms and 2.4% of patients without symptoms. Overall, about 40% of patients developed a fistula. Those with a history of anal issues and symptoms at the first check-up were significantly more likely to have their abscess come back, and fistulas were much more common in patients whose abscess recurred.

The study concluded that after an anal abscess is drained and cleaned, about half of patients will have it come back and 40% will develop a fistula, especially in the first year. Therefore, checking up on patients after this period may not be necessary. Also, using an ultrasound to check for fistulas may not be worthwhile if the patient isn’t showing any signs or symptoms.

FAQs

  1. What was the recurrence rate of anal abscesses after being drained and cleaned according to the study?
  2. What percentage of patients developed fistulas post anal abscess drainage and cleaning?
  3. How often and through what methods did researchers identify the presence of fistulas in the patients?

Doctor’s Tip

A doctor might advise a patient undergoing anal fistula surgery to closely follow post-operative care instructions, such as keeping the area clean and dry, taking prescribed medications as directed, avoiding strenuous activities, and following a high-fiber diet to prevent constipation. It is also important to attend follow-up appointments to monitor healing and address any concerns promptly. Additionally, the patient should be aware of the possibility of recurrence and the importance of seeking medical attention if any symptoms return.

Suitable For

Anal fistula surgery is typically recommended for patients who have recurrent anal abscesses and have developed a fistula as a result. Patients with a history of anal issues, symptoms at the first check-up, and recurrent abscesses are more likely to benefit from surgical intervention to prevent further complications. It is important for patients to follow up with their healthcare provider for proper evaluation and treatment recommendations.

Timeline

Before anal fistula surgery:

  • Patient may experience symptoms of an anal abscess, such as pain, swelling, and discharge
  • Patient may seek medical treatment for the abscess, which may involve draining and cleaning the abscess
  • Patient may undergo further tests to determine the presence of a fistula

After anal fistula surgery:

  • Patient may experience some pain and discomfort at the surgical site
  • Patient will be advised on wound care and pain management
  • Patient will be monitored for any signs of infection or complications
  • Patient may need to follow up with their healthcare provider for further assessment and treatment, especially if there are any signs of recurrence or development of new fistulas.

What to Ask Your Doctor

Some questions a patient should ask their doctor about anal fistula surgery may include:

  1. What is the success rate of anal fistula surgery in preventing recurrence of abscesses and fistulas?
  2. What are the potential risks and complications associated with anal fistula surgery?
  3. What is the expected recovery time after anal fistula surgery?
  4. Will I need to make any lifestyle changes or follow any specific post-operative care instructions?
  5. How will the surgery affect my bowel movements and anal function?
  6. Is there a possibility of developing complications such as incontinence or infection after the surgery?
  7. Will I need any follow-up appointments or additional treatments after the surgery?
  8. What are the alternative treatment options for anal fistulas, and why is surgery recommended in my case?
  9. How experienced is the surgeon in performing anal fistula surgery, and what are their success rates?
  10. Are there any specific dietary or activity restrictions I should follow before and after the surgery?

Reference

Authors: Chaveli Díaz C, Esquiroz Lizaur I, Eguaras Córdoba I, González Álvarez G, Calvo Benito A, Oteiza Martínez F, de Miguel Velasco M, Ciga Lozano MÁ. Journal: Cir Esp (Engl Ed). 2022 Jan;100(1):25-32. doi: 10.1016/j.cireng.2021.11.012. Epub 2021 Dec 6. PMID: 34876366