General risks

·      Wound infections – This is due to the proximity to the anus. We take precautions. You will receive antibiotics at the time of operation. You will also go home with a course of antibiotics. If you are prescribed metronidazole – please don’t drink alcohol while taking it.

·      Pain – Peri-anal region is a very pain sensitive area. We will infiltrate the operative site with local anaesthetic agents and the anaesthetist will give you pain relief intra-operatively. Please take regular pain relief for about 3 -5 days when you are discharged.

·      Bleeding – This is usually small volume and will settle with time. Risk is higher if you are on blood thinners.

·      5% chance of recurrence – Recurrence is a common issue after any operations for peri-anal fistula. This is mainly due to missing a minuscule fistulous tract that can’t be demonstrated at the time of the operation.

·      Risk of incontinence – As the procedure involves examination of your rectum with finger and proctoscope, there is a small risk of incontinence. This occurs due to stretching of anal muscles. If this occurs, it will be only for air and liquid stools. This will settle with time. However, major incontinence is unlikely – given that if the fistula is traversing anything more than few millimetres of the anal muscles, a lay opening will not be undertaken.

·      Deep venous thrombosis (DVT) and pulmonary embolism (PE) – as it is going to be a day case and you are expected to be mobile soon after you recover, the risks are low. We will use automatic compression boots and stocking to reduce the risks. Please mobilise as much as you can after the operation and drink plenty of water to help. If you smoke, or if you do take contraceptive pills or if you have a history of clots or increased risk of clotting – then you need to be extra causes and it is worthwhile using the stockings for at least 2 weeks after the operation.

·      General anaesthetic (GA) risks - These will be explained to you by the anaesthetist on the day. Risks are low and will depend on your previous medical history

Post op care

·      You will recover in the ward and will be discharged on the same day

·      As you had general anaesthesia – you are expected to be accompanied by an adult for at least 24h

·      Please mobilise as much as you can after the operation and drink plenty of water.

·      Take regular pain relief (will be supplied on discharge) at least for about 5 days

·      You will go home with a course of antibiotics. If you are prescribed metronidazole – please don’t drink alcohol while taking it.

·      Please do ‘sitz baths’ – Please sit on a hot and salty bathtub (a basin will be a cheaper option, in terms of energy and water usage) for 10 min in the morning after going to the toilet and cleaning and again before going to bed in the night. Water should be warm enough to feel warm and you can add ordinary salt to it to taste salty. Sitz baths have a soothing effect, help reduce pan and aid wound healing.

·      The wound will need dressing by your GP. Please make contacts with your GP practice to arrange this, starting the two days after the operation.

·      You will need some laxatives (suggest laxido 1 sachet in the night) to keep your bowels soft until the wounds heal.

·      Please don’t drink alcohol for 2 days after the operation

·      ·      You will see me for a post op check-up at the hospital in 3 months. Please meet your GP if you have any concerns unrelated to the operation.

·      After discharge - you will receive a telephone call from the nurses to see how you are. However, if you have any concerns after the operation, please ring the Oaks ward (number will be given on discharge) and speak with a nurse who will escalate your concerns directly with me.

·      Please ask the nurses if you need a sick note