I'm a 24 year old guy who recently had an anal abscess for the first time in my life almost a month ago. I went to see a specialist who drained the abscess and told me to see him again after 3 weeks to make sure that an anal fistula would not form. I went to see him a few days ago and just my luck, he said that he saw a fistula. Right after the removal of the abscess and up until now, there has been no pain. I've been able to work out and exercise and live normally.

My questions are:
1. Should I get an anal fistula surgery right away even if I am not experiencing pain right now? Will the fistula become bigger and lead to pain if I hold off on the surgery?
2. Should I have my doctor do an ultrasound first before going into the surgery to determine the scope of the fistula?

I'm afraid my life might turn 180 again if I go through the surgery considering I am not in any sort of pain right now. In most of what I've been reading in this forum, people get the fistulotomy because they are currently in pain. Is there anyone out there who went through the surgery feeling fine and just wanted to get rid of the fistula for sure? Any advice would be appreciated.

Hi newyorkguy,

I believe the problem with a fistula is it will keep getting infected. Often in a repeating cycle of healing, and re-infection. It's possible that draining the abscess wasn't sufficient and hence a fistula has formed. This happens in about 50% of cases.

I would suggest getting an MRI (if you can) to determine the extent of the fistula, and then going for surgery sooner rather than later. Unfortunately from what I've read this very rarely sorts itself out.

Fistulotomy is one of a few approaches that could be explored in resolving this though - depending on what your specialist thinks is most appropriate. There are at least five options - see here: http://www.nhs.uk/Conditions/Anal-fistu ... tment.aspx

Sorry I couldn't offer up more positive vibes.

Good luck! LemonMan

Also if it's a simple fistula then the surgery is not all that involved. Your discomfort after surgery should be short lived.

Like the above poster said though, you need to get it taken care of sooner rather than later.