Treatment of a fistula tract – OP

If a fistula tract has formed, there are often no treatment alternatives to surgery. Whether or which intervention is indicated depends on which organs are affected, where the fistula is located and what the causes are. It is also important whether the fistula tract causes symptoms or whether there is a risk of complications such as inflammation if treatment is not carried out.

Depending on the situation, the fistula tract is either peeled out or split by a longitudinal incision, exposed and cleaned. The latter is also called fistulotomy. An alternative treatment method to surgery is the so-called suture drainage. With some anal fistulas, a silicone thread can be inserted into the fistula duct so that it can heal without surgery.In the case of recurrent fistulas, such as in the chronic inflammatory bowel disease Crohn’s disease, this procedure can also counteract the development of new fistula ducts.

Risks of a fistula tract

The risks of an untreated fistula tract depend on which organs are involved and the cause. In a fistula tract between the intestine and the bladder, the passage of intestinal germs into the bladder can lead to recurrent and serious urinary tract infections. Untreated anal fistulas can cause severe pain, damage to the sphincter muscle and loss of continence.

In the worst case, an inflamed fistula duct can also lead to life-threatening blood poisoning. The risks associated with a fistula tract are counterbalanced by the risks of surgical removal, which must be weighed against each other in each individual case. General risks are special risks depending on the location of the fistula tract. This can lead to injuries of surrounding structures such as nerves, blood vessels or hollow organs.

Bleeding,
Inflammations,
Wound healing disorders and
Possible side effects due to anaesthetics.

Duration of a fistula tract

Depending on its cause and size, a fistula tract can develop within a few days in the case of an acute inflammation or it can grow slowly over a longer period of time. With targeted treatment, an inflammation can heal quickly, but the fistula tract does not disappear of its own accord but remains until surgical removal if necessary. The duration of such an operation depends on various factors such as size, extension and localization of the fistula tract. In the case of a simple coccyx fistula, the actual procedure often takes only a few minutes, while complicated fistula ducts between internal organs can also require more complex operations lasting several hours.