Persistent Discharge Near Buttock : Is It Anal Fistula and What Treatment Should I Choose
2 weeks ago
I started having a painful lump near my left buttock a few months ago, which later burst and discharged pus. After antibiotics, the size reduced but I still have continuous discharge and occasional bleeding. A surgeon examined me and said it could be a perianal abscess with anal fistula and suggested procedures like seton placement, fistulotomy, or LIFT. I’m not comfortable with seton and want to understand what the best treatment option is. Do I really need surgery, and how do I decide which procedure is right?
Answers (1)
Based on your symptoms recurrent discharge, previous abscess, and a tract formation—it is likely an anal fistula, which usually does not heal on its own and often requires treatment.
However, before deciding the procedure, it is very important to first identify the exact tract and internal opening through investigations like MRI or fistulogram. Treatment options such as seton placement, fistulotomy, LIFT, or laser (FILAC) depend on the depth, location, and involvement of sphincter muscles.
Each method has its pros and cons, including different recovery times and recurrence risks. Seton is a safe initial option in many cases, especially for deeper tracts, while laser or LIFT may be considered if anatomy is suitable. So, the best next step is proper imaging and clinical evaluation only then can the most suitable and safe treatment be chosen.
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