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Anal fistula natural history, complications and prognosis

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%.

Natural History

  • 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

References

  1. 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.
  2. 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.

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