It can cause discomfort, pain and recurrent infections, significantly affecting the patient’s quality of life. Therefore, the proper evaluation of the symptoms is considered necessary in order to formulate the appropriate treatment plan. THE Mr. Dimitrios Mousiolis General SurgeonDirector of the 1st Surgical Clinic for Minimally Invasive Endoscopic Rectal and Anal Surgery Metropolitan General, explains what a periosteal fistula is, how and why it is created, what are the symptoms and what is its treatment:

What is a periodontal fistula?

An anal fistula is an abnormal passage that forms between the anal canal or rectum and the skin surrounding the anus. An anal or perianal fistula is usually the result of an infection of an anal gland. If one of the anal glands becomes infected, a painful abscess containing pus forms.

If the abscess is not completely drained and does not heal properly, it can create a passageway that allows fluid or pus to pass between the infected gland and the surrounding tissues, a periodontal fistula.

It usually starts inside the anus or rectum and spreads to the skin around the anus. Cervical fistulas can vary in complexity and severity. Some may be simple, while others may be more complex, involving multiple ramifications.

Symptoms and the impact on a person’s daily life can also vary depending on the characteristics of the fistula.

Periodontal fistula and symptoms with which it manifests

Cervical fistulas often develop due to the formation of anal abscesses that have not been properly drained. These abscesses are painful, swollen and filled with pus. If an abscess recurs in the same location or if multiple abscesses develop, this may indicate the presence of a cervical fistula.

If it develops, a periodontal fistula can either remain asymptomatic for some time or manifest itself with unpleasant symptoms, the main of which are pain and discomfort. The pain around the anus is particularly noticeable, especially during bowel movements. This pain can vary in intensity and can be sharp or persistent.

There may also be discomfort when the patient sits or walks. At the same time, a periodontal fistula manifests itself with additional symptoms such as the discharge of foul-smelling fluid that may be accompanied by pus or blood.

This discharge can stain underwear and cause irritation or itching around the anus. The presence of an anal fistula can also lead to local swelling and varying degrees of inflammation around the external fistula duct. This swelling or inflammation is usually accompanied by redness and tenderness in the affected area.

Treatment options for periodontal fistula and the symptoms it causes

The treatment of a peroneal fistula depends on several factors, including its complexity and location, as well as the individual characteristics of the patient. The primary goals of treatment are symptom relief, healing, and prevention of recurrence. The optimal therapeutic approach to a peroneal fistula is usually surgical, as conservative management measures do not provide substantial results and spontaneous healing is considered unlikely. Until recently, surgical treatment for a periodontal fistula and the symptoms it causes was performed with open surgery. However, new, minimally invasive techniques have emerged for the successful treatment of the condition, which minimize potential complications.

These non-invasive options are the FIXcision technique and laser treatment. With the FIXcision technique, it is possible to remove the fistulous tissue in three simple steps. Finally, the periosteal fistula is treated using a special laser, which causes thermal destruction with great precision of the epithelial tissue of the fistula causing its walls to close. The operation is short, bloodless and almost painless. No surgical trauma is created, and patients can return to their daily activities the same day.

“It is important for every patient to seek medical attention if they suspect a peroneal fistula. Only a qualified physician can assess the situation, confirm the diagnosis and suggest the most appropriate treatment approach based on the characteristics of each individual case. Early diagnosis and appropriate treatment can help relieve symptoms, prevent complications and improve the overall quality of life of patients,” concludes Mr. Mousiolis.