What is anal fistula?
An anal fistula is an abnormal tunnel connecting an infected anal gland to the skin near the anus. It usually follows an abscess and presents with recurrent discharge, swelling and pain. Fistulas do not heal spontaneously because the tract stays lined and infected.
The art of fistula surgery is clearing the tract completely while preserving the anal sphincter, so continence is protected. Dr. Reddy uses techniques matched to the fistula's complexity — from simple laying-open of low fistulas to VAAFT and laser (FiLaC) for higher or branching tracts.
Symptoms & when surgery is needed
How it is diagnosed
- Clinical examination to find the external and internal openings
- MRI fistulogram to map complex or recurrent tracts and branches
- Endoanal ultrasound in selected cases
- Examination under anaesthesia to define the tract precisely before treatment
Treatment options
VAAFT (video-assisted)
A tiny scope visualises the tract from within, so it is cleared and sealed accurately without cutting the sphincter.
Laser (FiLaC)
A radial laser fibre seals the tract from inside — sphincter-preserving with minimal wound and quick recovery.
Fistulotomy
Laying open a simple, low fistula — a reliable option when the sphincter is not at risk.
LIFT / advancement flap / seton
Sphincter-saving procedures for complex, high or recurrent fistulas, sometimes staged with a seton first.
The procedure, step by step
- 1
Mapping
The tract is defined clinically and, for complex cases, with an MRI fistulogram.
- 2
Anaesthesia
Surgery is performed under spinal or general anaesthesia as day-care or a short stay.
- 3
Tract clearance
The tunnel is cleaned of infected tissue via VAAFT, laser or direct techniques.
- 4
Sphincter-saving closure
The internal opening is sealed while protecting the muscle, using the method suited to the fistula.
- 5
Recovery plan
Dressings, hygiene and follow-up are explained; most patients go home the same day.
Recovery timeline
Same day
Home within hours for most laser and VAAFT cases.
3–5 days
Return to desk work; sitz baths and dressings continue.
2–4 weeks
The wound heals steadily with regular hygiene.
6–8 weeks
Complex tracts heal fully; follow-up confirms closure.
Risks & considerations
- Recurrence, which is higher for complex tracts and reduced by accurate mapping
- Temporary discharge or discomfort during healing
- Small risk of continence changes with complex fistulas — minimised by sphincter-saving methods
- Delayed healing needing extended care in some cases
Cost in Hyderabad
| Procedure | Indicative range |
|---|---|
| Laser fistula surgery (FiLaC) | ₹55,000 – ₹1,00,000 |
| VAAFT (video-assisted) | ₹70,000 – ₹1,30,000 |
| Simple fistulotomy | ₹35,000 – ₹65,000 |
| Complex / recurrent fistula surgeryMay be staged with a seton | ₹90,000 – ₹1,80,000 |
These are indicative ranges for Hyderabad and vary with the grade or complexity of the condition, the technique chosen, implants used, room category and insurance. They are not a quotation. Please contact the clinic for a personalised estimate after consultation.
Why choose Dr. Satish Reddy
Frequently asked questions
Almost never. A fistula is a lined tunnel that stays infected, so it does not close on its own. Antibiotics may settle a flare-up temporarily, but definitive treatment requires surgery to clear and seal the tract.
VAAFT (Video-Assisted Anal Fistula Treatment) uses a tiny scope to see inside the tract, so it can be cleared and sealed precisely without cutting the anal sphincter. This protects continence and suits complex or high fistulas.
Sphincter-saving techniques such as VAAFT, laser (FiLaC) and LIFT are chosen specifically to preserve the muscles that control continence. Accurate mapping and the right technique keep this risk very low.
Recurrence usually happens when a branch or the internal opening is missed. MRI mapping and complete clearance of the tract, as Dr. Reddy performs, are the keys to preventing recurrence.
Medically reviewed by Dr. Y. Satish Reddy
MS, PDF (Surgical Gastroenterology) · Updated 1 September 2026