Male cryptoglandular fistula surgery outcomes: a retrospective analysis

Abstract 

Purpose

The purpose of this study was to evaluate cryptoglandular fistula surgery outcomes in men with common types of fistulae.

Method

A database review identified study patients. Exclusion criteria included history of previous fistula, previous anorectal surgery, inflammatory bowel disease, pelvic radiation, complex fistula, age <21 years, and absence of follow-up.

Results

Four hundred twenty-five patients met criteria for review. Mean follow-up was 5.8 years. Concurrent abscess at presentation was strongly associated with poorer outcomes. New-onset seepage is more common with seton treatment (P = 0.01), but seepage resolution occurred less commonly with fistulotomy (P <0.01).

Conclusions

Although both treatments are highly successful, men treated with primary fistulotomy are more likely to heal than seton patients. Fistulotomy patients have less early postoperative seepage than seton patients, but when this is present it is less likely to resolve. Presentation with concurrent abscess is strongly associated with poorer outcomes.

Keywords: Male, Fistula, Cryptoglandular, Recurrence, Incontinence, Anal, Outcomes