Anal fistula natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Anal fistula usually develops in 20-30 years of age and peaks around 40 years. If left untreated, patients with anal fistula may progress to develop the perianal abscess and cancer. Common complications of anal fistula include: urinary retention, bleeding, perianal abscess, fecal incontinence, carcinoma. Prognosis is excellent after surgery and recurrence rate is 7-21%.

The symptoms of anal fistula usually develop in the second and third decade of life and peaks around 40 years.
If left untreated, patients with anal fistula may progress to develop the perianal abscess and cancer.

Common complications of anal fistula include:

Prognosis is excellent after the surgery.
Recurrence rate is 7-21% depending upon the anatomy and complexity of fistula.^[1]^[2]

↑ van Koperen PJ, Wind J, Bemelman WA, Bakx R, Reitsma JB, Slors JF (2008). "Long-term functional outcome and risk factors for recurrence after surgical treatment for low and high perianal fistulas of cryptoglandular origin". Dis. Colon Rectum. 51 (10): 1475–81. doi:10.1007/s10350-008-9354-9. PMID 18626715.
↑ Abbas MA, Jackson CH, Haigh PI (2011). "Predictors of outcome for anal fistula surgery". Arch Surg. 146 (9): 1011–6. doi:10.1001/archsurg.2011.197. PMID 21930996.