Fistula and Fissure Surgery: What to Expect
When it comes to anorectal conditions, few things are as uncomfortable—or as misunderstood—as anal fissures and fistulas. At Suncoast Surgical Associates, our board-certified colorectal surgeons specialize in helping patients find lasting relief through compassionate, evidence-based care.
If you’ve been advised to undergo surgery, here’s what you can expect—and why you’re in good hands.
What’s the Difference Between a Fissure and a Fistula?
A fissure is a small tear in the lining of the anus, typically caused by trauma from constipation, straining, or tight sphincter muscles. It causes sharp pain during bowel movements and often mild bleeding.
A fistula, on the other hand, is a tunnel that develops between the anal canal and skin, usually after an abscess or infection. It may cause persistent drainage or discomfort.
Both conditions can become chronic and may require surgical treatment when conservative options—like topical creams, sitz baths, or dietary changes—aren’t enough.
(Engebretsen et al., 2016; Park et al., 2023)
When Is Surgery Needed?
For Anal Fissures
If symptoms last longer than six to eight weeks, a procedure such as lateral internal sphincterotomy (LIS) or fissurectomy may be recommended. These surgeries relax the anal muscles and improve blood flow to promote healing.
Studies show that surgical treatment for chronic fissures provides long-term relief with very low risk of recurrence or complications.
(Madoff et al., 2003; Zeitoun et al., 2018)
For Anal Fistulas
Because fistulas rarely heal without surgery, a fistulotomy or seton placement is often performed to remove the tract and prevent reinfection.
Modern sphincter-sparing techniques have healing rates above 90% while minimizing incontinence risk.
(Burney et al., 2021)
What to Expect at Suncoast Surgical Associates
Before Surgery
You’ll meet with one of our colorectal specialists for a full evaluation, which may include imaging (like MRI) to map the fistula or assess sphincter involvement. We’ll review your medications, diet, and steps to prepare your bowels safely.
During Surgery
Most procedures are outpatient and performed under anesthesia.
Fissure surgery: The tight sphincter muscle is partially released or scar tissue removed.
Fistula surgery: The tract is opened or cleaned while preserving sphincter function.
Our surgical team uses advanced, minimally invasive techniques to ensure optimal healing and comfort.
Recovery
After surgery, mild pain and drainage are common for a few days. You’ll receive instructions for sitz baths, wound care, and pain management.
Most patients resume normal activities in 2–4 weeks, with complete healing over several weeks.
Regular follow-up helps ensure full recovery and early detection of recurrence.
Why Choose Suncoast Surgical Associates?
At Suncoast Surgical Associates, we focus on:
Expert colorectal care using evidence-based methods
Minimally invasive techniques that preserve sphincter function
Personalized recovery plans to ensure comfort and confidence
Proven outcomes, supported by the latest clinical research
Our goal is to restore your comfort and quality of life—safely and compassionately.
Anal fistula and fissure surgeries are safe, effective, and life-changing when performed by experienced colorectal specialists. The team at Suncoast Surgical Associates provides comprehensive care from consultation through recovery—helping you heal with confidence, backed by science.
Works Cited
Burney, R. E., et al. (2021). Long-term results of surgical treatment of anal fistula in a tertiary centre. Journal of Coloproctology, 41(4), 281-288. Link
Engebretsen, K. A., Johansen, J. D., Kezic, S., Linneberg, A., & Thyssen, J. P. (2016). The effect of environmental humidity and temperature on skin barrier function and dermatitis. Journal of the European Academy of Dermatology and Venereology, 30(2), 223-249. Link
Madoff, R. D., & Nichols, F. C. (2003). Diagnosis and care of patients with anal fissure: AGA technical review. Gastroenterology, 124(1), 233-239. Link
Park, E. H., Jo, D. J., Jeon, H. W., & Na, S. J. (2023). Effects of winter indoor environment on the skin: Unveiling skin condition changes in Korea. Skin Research and Technology, 29(1), e13397. Link
Zeitoun, J. D., et al. (2018). Long-term outcome of a fissurectomy for chronic anal fissure. Annals of Coloproctology, 34(3), 144-149. Link