Most anal fistulas will not heal on their own and require medical intervention. There are a variety of treatment options. Some approaches require cutting the anal sphincters, which may cause fecal incontinence.

Biodesign Fistula Plug
The Biodesign Fistula Plug is the first minimally invasive alternative to traditional anal fistula surgery. This cone-shaped device is an advanced tissue repair graft that communicates with your body, signaling surrounding tissue to grow across and into the plug, allowing your body to restore itself. It’s a natural material that also allows your body’s immune system to help the plug resist potential infection.

Once the body’s natural healing process is finished, the graft is undetectable, having completely remodeled into your own strong tissue. Plus, fecal incontinence is unlikely, as the placement of the plug does not require cutting the anal sphincters.

View our patient guide for illustrations and more detailed information.

Surgery
A common treatment for anal fistulas is a surgical procedure called a fistulotomy. In this procedure, the surgeon makes an incision in the fistula tract, opening it up and merging it with the anal canal. This allows the tissues to heal from the inside out. Patients typically experience mild or moderate discomfort or pain following this procedure, with a recovery time of 1-4 weeks.

Seton
For deeper fistulas the physician may choose to use a seton. A seton is a piece of suture material that is passed from the external skin opening, along the fistula tract, through the internal opening in the anal canal, exiting through the anus. The suture material is then tied in a loop. The seton can be left loose to allow the fistula to drain or the seton may be gradually tightened over a period of weeks. This is a cutting seton and ultimately has the same effect as a fistulotomy.

Fibrin Glue
In some cases, an anal fistula is closed by the injection of fibrin glue—a solution of the clotting factors fibrinogen and thrombin.

Endorectal Advancement Flap
This is a surgical procedure typically reserved for more complex fistulas. In the operating room, the doctor uses surgical instruments to dissect and lift a portion, or flap, of the rectal wall adjacent to the internal opening. The doctor pulls the flap down over that opening and sutures it into place to close the opening.

Rectovaginal fistulas resulting from giving birth or surgery often heal on their own within a period of 6-12 weeks. Those that do not heal within this time frame may require some form of repair. Some approaches require cutting the anal sphincters, which may cause fecal incontinence.

Biodesign Fistula Plug
The Biodesign Fistula Plug is the first minimally invasive alternative to traditional rectovaginal fistula surgery. This cone-shaped device is an advanced tissue repair graft that communicates with your body, signaling surrounding tissue to grow across and into the plug, allowing your body to restore itself. It’s a natural material that also allows your body’s immune system to help the plug resist potential infection.

Once the body’s natural healing process is finished, the graft is undetectable, having completely remodeled into your own strong tissue. Plus, fecal incontinence is unlikely, as the placement of the plug does not require cutting the anal sphincters.

View our patient guide for illustrations and more detailed information.

Surgery
Some fistulas that are located high in the rectum/vagina may need to be repaired transabdominally. The surgeon makes an incision in the abdomen to gain access to the fistula. Then an incision is made that divides the fistula tract. When the incision heals, the tissues grow together, eliminating the fistula.

Fibrin Glue
In some cases, a rectovaginal fistula is closed by the injection of fibrin glue—a solution of the clotting factors fibrinogen and thrombin.

Transanal Advancement Flap
In this approach, the doctor dissects and lifts a portion, or flap, of the rectal wall adjacent to the fistula opening. The doctor then pulls the flap down over that opening and sutures it into place to close the opening. The fistula opening on the vaginal side is left open for drainage.