Fistula in ano is very notorious disease for its recurrence. Most of the people suffering from fistula are frustrated due to soiling of clothes with the pus and blood. Also so after operation most of the cases forms fistula again in the same track or with bifurcation.
So good surgeon and right choice of treatment is necessary in the treatment of fistula. In all the complicated fistula MRI should be done prior to operative because it gives a clear picture about the fistulous tract. By this method, false probing at the time operation can be controlled. All the typical fistula have origin from infected anal gland while atypical fistula may have tuberculosis or another type of origin.
In all typical fistula, the surgeon must have to concentrate on the anal gland in infection. Most of the anal glands are situated posteriorly in the anal canal. So while treating the fistula, one must take care of curating or destroying the anal glands situated posteriorly which is the main cause of fistula in ano.
Most of the fistula is not a single track but consists of an abscess in their track mean some collection is there. When there is some pus collection, their laser doesn't work or simply one can say it is not indicated in the abscess cavity. So while taking such cases you have to cure it abscess cavity and train all the pus and fibrous tissue away from the pathology. For this purpose, one can use Pratiksharaniya kshara over the abscess cavity and fistulous tract. Window method is indicated in such cases. In that linear track is updated with pleasure and the track from the anal canal up to the abscess cavity is kept open for or ksharsutra is placed in that remaining part, to drain the cavity. One can apply Pratisarniya kshara over the abscess cavity and the track nearer to the anal canal. This is the very best method for treating fistula which has an abscess cavity.
The laser gives the benefit of rapid healing of the track and kshara drain the cavity by its action very well.
Dr Atul Patil
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