Fistula

Types of Fistulas

Dr. Ali Shafik explains the different types of fistulas and the best treatment approaches for each:

1- Anal Fistula

An anal fistula is an abnormal tunnel that forms between the anal canal and the skin surrounding the anus. It often results from an untreated or improperly healed anal abscess, leading to the formation of a small passageway between internal and external tissues.

Types of Anal Fistulas:

• Simple Fistula: A direct channel connecting the infected gland to the skin surface.
• Complex Fistula: Contains multiple branching channels and may extend into anal muscles.
• High-risk Fistula: Passes through the internal anal sphincter muscle, making treatment more complex.
• Recurrent Fistula: Occurs again after treatment due to incomplete healing or persistent infection.

Symptoms of Anal Fistula:

• Chronic pain around the anus.
• Pus or foul-smelling discharge from the affected area.
• Recurrent swelling or inflammation.
• Bleeding from the anal region.

Treatment of Anal Fistula with Dr. Ali Shafik

Dr. Ali Shafik offers both medical and surgical treatments for anal fistulas:

1. Medical Treatment:
   • A proper diagnosis, including lab tests and imaging, is essential before prescribing medication.
2. Surgical Treatments:
   • Fistulotomy: The fistula tract is opened completely to allow healing from the inside out. This method has a success rate of up to 90% for simple fistulas.
   • Seton Placement: A surgical thread is inserted into the fistula tract to facilitate gradual drainage, reducing the risk of incontinence.
   • Fibrin Glue or Bioprosthetic Plug: A medical adhesive or biological plug is used to seal the fistula, though success rates are lower than traditional surgery.
   • LIFT Procedure (Ligation of Intersphincteric Fistula Tract): The fistula tract is separated from the anal sphincter, promoting healing without affecting muscle function.
   • Advancement Flap Repair: Healthy tissue from the rectum or anus is used to close the internal opening of the fistula, recommended for complex or recurrent cases.

2- Rectovaginal Fistula

A rectovaginal fistula is an abnormal passage that forms between the rectum and the vagina. The rectum stores stool and gas until elimination, while the vagina connects the uterus to the external genitalia. A fistula in this area allows stool or gas to leak into the vagina.

Causes of Rectovaginal Fistula:

• Difficult childbirth: Deep vaginal tears during labor, especially with forceps or vacuum-assisted delivery.
• Gynecological or rectal surgeries: Such as hysterectomy or procedures for treating anal fistulas or hemorrhoids.
• Crohn’s disease: Causes chronic inflammation in the intestines, increasing the risk of fistula formation.
• Cancer: Tumors in the rectum or vagina can erode tissues, leading to fistula development.
• Radiation therapy: Pelvic radiation can damage healthy tissue over time.
• Severe infections or abscesses: Chronic inflammation in the vagina or rectum may result in fistula formation.

Symptoms of Rectovaginal Fistula:

• Abdominal pain and foul-smelling vaginal discharge.
• Passage of stool, pus, or gas through the vagina (fecal incontinence).
• Nausea, vomiting, or diarrhea.
• Pain during intercourse (dyspareunia).
• Frequent urinary tract infections or vaginal infections.
• Rectal or vaginal bleeding.
• Unexplained weight loss.

Treatment of Rectovaginal Fistula with Dr. Ali Shafik

Dr. Ali Shafik, a professor and head of colorectal surgery, treats rectovaginal fistulas using the latest medical and surgical techniques:

• Direct Surgical Closure: Small, newly formed fistulas can be surgically closed.
• Tissue Grafting: Healthy tissue from the vagina or rectum is used to cover the fistula, especially for complex or recurrent cases.
• Laparoscopic Repair: Used for deep fistulas or those associated with inflammatory diseases.

3- Colocutaneous Fistula

A colocutaneous fistula is an abnormal connection between the colon and the skin, allowing stool or intestinal fluids to drain through an opening on the skin’s surface.

4- Urinary Fistula

A urinary fistula is an abnormal connection between the urinary system—including the bladder, ureters, urethra, or kidneys—and neighboring organs such as the vagina, rectum, or skin. This leads to urine leakage into inappropriate areas, causing significant health issues.

Diagnosis of Fistulas with Dr. Ali Shafik

When visiting Dr. Ali Shafik, he will conduct a thorough diagnosis using various methods to determine the most suitable treatment approach:

• Clinical Examination: Identifying the location and symptoms of the fistula.
• Magnetic Resonance Imaging (MRI): Provides a detailed map of the fistula’s path.
• Computed Tomography (CT Scan): This offers a comprehensive evaluation of gastrointestinal fistulas.
• Fistulography: Uses contrast dye to outline the exact fistula trajectory.
• Endoscopy or Colonoscopy: Helps diagnose digestive system fistulas.

If you experience persistent pain in the anal or vaginal region, do not hesitate to visit Dr. Ali Shafik for expert treatment and relief from discomfort.