Anal Fistulotomy: Before Your Surgery

What is an anal fistulotomy?

An anal fistulotomy is a type of surgery. It opens and drains an anal fistula and helps it heal. An anal fistula is a small tunnel from the anal canal to a hole in the skin near the anus.

Your doctor will give you medicine to make you sleep or feel relaxed. The doctor will put a lighted tube called a scope into the anus. Then, using special surgical tools, the doctor will open the fistula so it can drain and heal.

After surgery, you may have gauze in the opening of your fistula. It may come out with your first bowel movement. Or your doctor may tell you to remove it 1 day after surgery.

You will probably go home the same day. Most people have very little pain after several days. You can probably go back to work or your normal routine in 1 to 2 weeks. Most people heal completely in several weeks.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• You may need to empty your colon with an enema or laxative. Your doctor will tell you how to do this.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.

What happens on the day of surgery?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery will take about 30 minutes.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.