Since the day known as perianal fistula disease, surgeons have been trying to treat the disease without damaging the anal sphincters that control the stool. However, the nature of the disease and its spread to the anatomical areas around the anus, which is not easy to identify, have caused recurrence of the disease and in most cases led surgeons to treat fistula using more sphincter discontinuation methods. Considering the value of anal sphincter muscle in the control of excretion, it seems that, if possible, prior to the decision to have a fistulectomy, all the procedures in which the sphincter is preserved should be used.

Learn more about new fistula treatments

Nowadays, there are several methods available to surgeons that can treat fistula without acceptable anal sphincter muscle failure. Common surgical procedures include the use of seton columns, fistula tracheal closure (LIFT) and rectal muscle mucosa (Advancement Flap), and the other is the use of materials as a fistula tract filler that can provide a scaffold for Has the growth of fibroblasts.

The oldest of these is fibrin glue, which is less popular with surgeons due to its use problems and high recurrence rate. Another product is a plug that is made from the pig intestinal mucosa and has been used in numerous patients in Iran and has had a success rate of about 60-70%. The high price of this product has limited its use. And finally, biological fillers are recently used substances that are in experimental stages and have not yet had the experience of using them in our country.

Considering the consequences of stool incontinence and its impact on people’s lifestyle, especially in the culture of our beloved country of Iran, it is necessary for the community of surgeons to invest in more sphincter preservation techniques.