Having surgery for an anal fistula isn’t easy, but for most people, it works out well in the end. Just like with any surgery, there are some risks involved—nothing is ever completely safe. Being aware of what could go wrong helps you prepare and hopefully avoid bigger problems. The truth is, the serious complications are rare, especially if you follow your doctor’s advice and take care of yourself.
Common Complications to Be Aware Of
Dealing with infections after anal fistula surgery? Yeah, that’s definitely something you don’t want to face. Just a tiny bit of bacteria can cause a lot of pain, swelling that makes it feel like you’ve sat on a bunch of bees, red skin, and some gross stuff oozing out that shouldn’t be there. If you’re running a fever, the pain gets worse even with pain meds, or the drainage smells really bad, don’t hesitate—call your doctor.
Now, about bleeding—everyone freaks out about blood, right? The good news is that a little spotting is normal for a few days post-surgery. If you find some on the gauze, that’s not a big deal. But if you’re soaking through pads or it’s still coming out strong after a week, then you definitely need to get help.
And then there’s the risk of the fistula coming back—yeah, that’s a tough one. Sometimes the tract doesn’t close up or a new one shows up, which is so frustrating. Depending on what kind of surgery you had and how complicated things were, around 5–20% of people face this issue again. Not the kind of odds you want to deal with.
Serious But Rare Complications
Incontinence—basically, losing bowel control—is honestly one of the most concerning complications after this type of surgery. It can be as minor as the occasional slip of gas, or as serious as losing total control. The main risk factor? How much muscle the surgeon needs to cut through. The more muscle involved, the bigger the risk.
Anyone considering anal fistula surgery, especially for those more complex fistulas that dig deep into the muscle layers, should absolutely cover this topic in detail with their surgeon. Surgeons with a lot of experience tend to use specific methods to spare as much of the muscle as possible and, by extension, minimize the chance of incontinence.
Chronic pain or ongoing discomfort is another possibility—usually pops up if there’s nerve damage or if scar tissue decides to heal in some weird, unhelpful way. Most people get solid pain relief after a successful surgery, but yeah, there’s always a chance of lingering pain. It’s not the norm, but it’s definitely a risk worth knowing.
Prevention Strategies
When it comes to choosing someone to check out your colon, you want an experienced doctor—not someone fresh out of med school. The ones who do these procedures regularly? They make fewer mistakes. So don’t hesitate to ask them how many they’ve done and if anything has gone wrong before. You’re the one on the operating table, after all.
After the surgery, don’t try to tough it out—just stick to the instructions. Keep things clean, take your antibiotics as prescribed, and avoid lifting heavy stuff. And those follow-up appointments? Make sure you keep them, even if you’re feeling good.
When it comes to preventing infections, it’s usually about good hygiene. Just use warm water, clean gently, and change out the bandages. If you notice any redness, ooze, or anything that looks off, reach out to your doctor. There’s no need to wait until it gets really bad.
When to Seek Help
Contact your surgeon immediately if you experience severe pain that doesn’t improve with medication, signs of infection, heavy bleeding, or any concerns about your recovery. Taking action early can prevent bigger issues down the road.