Fistula of the rectum is a chronic inflammatory disease of the anal area. As a rule, acute paraproctitis leads to the formation of a fistula. In 30-50% of cases after paraproctitis, an internal fistula is formed in the area of the anal crypt and anal gland and a purulent passage forms in the subcutaneous tissue. The external opening can be located in the perineum, near the anus, on the buttock, in the vagina. In the course of the fistula, inflammatory infiltrates and cavities can form.
The most common manifestations of the disease are:
• the presence of fistulous openings (wounds) on the skin near the anus;
• the allocation of pus, a sac from the fistulous opening, in connection with which, patients are forced to wear pads, wash the perineum or sitz baths;
• often due to constant discharge from the fistulous opening, patients complain of itching, burning, a feeling of moisture in the anus;
• pain, as a rule, is rarely disturbed, they appear during a wave-like course of the disease, when the fistulous passage is blocked by pus or dead tissue, which leads to accumulation of pus in the tissue along the fistula and exacerbation of the inflammatory process.
Treatment of fistula of the rectum is only surgical. Depending on the complexity of the fistula, the following methods are used: dissection or excision of the fistula into the lumen of the rectum, excision of the fistula with the opening and drainage of purulent sagging, excision of the fistula with suturing of the sphincter or ligature.
Along with the classical types of operations, we widely apply modern techniques. We prefer the modern low-traumatic method of segmental proctoplasty, which consists in reducing a full-layer flap of the intestinal wall. This type of surgery can significantly reduce the risk of developing anal incontinence, reduce the healing time of the wound, and, accordingly, the recovery time after surgery with a speedy return to your normal life.