Prognostic factors for recurrence following the initial drainage of an anorectal abscess

It is well known that recurrent abscesses and anal fistulas may develop following incision and drainage. In this study, the prognostic factors for recurrence of anorectal abscess were retrospectively examined following initial drainage.

Between November 2003 and April 2008, 205 patients with a diagnosis of anorectal abscess underwent initial incision and drainage at our hospital. We included only patients experiencing anorectal abscess for the first time, which represent the majority of anorectal abscess patients seen in regular clinical practice.

Of the total of 205 subjects, 74 experienced recurrence and 131 were cured (without recurrence). An investigation on the prognostic factors for recurrence revealed that the time from disease onset to incision was the only significant prognostic factor (p = 0.001). Sex, age, body mass index, method of anesthesia, abscess location, anatomic classification, use of a drain, and comorbid diabetes mellitus had no influence on recurrence. The cumulative cure rates were 68.7% for 1 year, 64.2% for 2 years, and 63.5% for 3 years.

For patients undergoing incision and drainage of anorectal abscesses, obesity did not affect recurrence. Prompt incision of anorectal abscesses was important to avoid recurrence.