Anal Warts, Fissure And Fistula Surgery
What are Anal Warts?
Anal warts are small excess growths of skin that appear around your anus, they are caused by a virus called human papilloma virus or HPV. These are common and can be removed using a range of different methods such as:
- Electrocautery- is also known as diathermy. In this procedure, the warts are burnt off using a low-voltage electric current through a thin wire or probe. This method also immediately seals the blood vessels, meaning no stitches are needed.
- Loop electrosurgical excision procedure (LEEP) - this procedure is very similar to electrocautery, but the wire or probe has a loop on the end to remove the warts.
- Surgical Removal- the warts are cut away using a scalpel. Then the wound is then closed using dissolvable stitches.
- Laser Ablation- This is where a high-energy beam of light is used to destroy the warts. The method seals the blood vessels meaning you will not need stitches.
Surgery to remove anal warts is usually done under general anaesthesia, if the warts are very small it may be done under a local anaesthetic. Usually the operation is done as a day-case, requiring no overnight stay.
What is an Anal fissure?
An anal fissure is a tear in the skin lining of the anus. These can be caused by constipation, if the skin tears, the muscle underneath can potentially go into spasm. This then leads to the anus tightening further making it more painful and difficult to open your bowels, particularly if you remain constipated.
An anal fissure has the potential to heal on its own; this healing process can be helped by eating lots of fruit and vegetables, and drinking lots of fluids to avoid being constipated.
However, an anal fissure may need surgical treatment. Anal sphincterotomy surgery is the process of making a cut in the ring of the muscle (the sphincter) that controls the opening and closing of the anus. This allows for the sphincter to relax and help prevent it from going into spasm. After the procedure, a pad dressing will be put into your anus to help stop bleeding.
The operation is performed under general anaesthetic, which means during the procedure you will be asleep and will feel no pain. The operation is usually done as day case procedure, but sometimes you may need to stay overnight in hospital.
What is an Anal Fistula?
An anal fistula is a tunnel connecting the skin near the anus to the inside of the bowel (usually the rectum). This essentially means that the inside of the bowel is connected to the outside of the body through an additional opening. A fistula is usually the result of an infection or abscess in the anus.
Anal fistula’s can form into different types. Some may be single tract (route) running from the bowel to the skin. Others branch off into more than one tract; they can also cross the muscles that control the opening and closing of the anus. There are also other side effects, a fistula may cause the skin around the anus to swell, and your skin may itch excessively, be irritated and infected. Surgical treatment will be needed to remove them. The exact surgery is very much dependent on the type of fistula you have this will be discussed with your surgeon. The operation will be performed under general anaesthetic so you will not feel anything during the operation.
Side Effects and Risks
Anaesthetics are made up from a combination of medicines that can cause side effects in some people who may be sensitive to the medications. Your anaesthetist will give information on these side effects to you and what measures will be taken to reduce these. Some of the common side effects that can occur:
- Feeling sick or vomiting
- Headaches, dizziness and feeling faint
- Feeling cold and shivering
- Bruising and soreness
- Difficulty passing urine
- Aches and pains
Serious problems are rare in these types of procedure, and as with any type of surgery or medical procedure, there is a potential risk of complications. These very rare possible complications include:
- Permanent nerve damage, there is a possibility of paralysis this may be a result of the surgery itself: this peripheral nerve damage 9the peripheral nerves run between the spinal cord and the rest of the body) occurs in less than 1 in 1,000 anaesthetics.
- Allergic reaction to an anaesthetic medication (anaphylaxis) this can be severe but there treatment is always on hand during any procedure or operation to enable the best chance of dealing with this effectively.
- Death: In the UK, it is approximately 10 deaths for every million anaesthetics given.