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Rules for anal fistulas with scrotal extension
Yoshiro Araki1, Ryuzaburo Kagawa1, Hiroshi Yasui2
1Department of Proctology, Rakuwakai Otowa Hospital.
Journal of the Anus, Rectum and Colon
|October 5, 2019
Summary
Anal fistulas extending to the scrotum typically originate from anterior internal openings. High transsphincteric or suprasphincteric fistulas rarely involve the scrotum, except in recurrent cases.
Area of Science:
- Colorectal Surgery
- Anorectal Diseases
- Surgical Anatomy
Background:
- Anal fistulas with scrotal extension present a complex surgical challenge.
- Understanding the origin of these fistulas is crucial for effective treatment planning.
Purpose of the Study:
- To investigate the anatomical characteristics of anal fistulas with scrotal extension.
- To determine the relationship between the internal opening location and scrotal involvement in anal fistulas.
Main Methods:
- Retrospective analysis of 446 male patients undergoing anal fistula surgery.
- Comparison of fistulas with scrotal extension based on anterior vs. posterior internal opening location.
Main Results:
- 82.1% of anal fistulas with scrotal extension had anterior internal openings.
- The relative risk of scrotal extension was significantly higher for anterior openings (14.22 times).
- Recurrent fistulas showed an even higher risk (18.67 times) for scrotal extension from anterior openings.
Conclusions:
- Anal fistulas with scrotal extension predominantly arise from low transsphincteric or intersphincteric fistulas with anterior internal openings.
- High transsphincteric or suprasphincteric fistulas rarely extend to the scrotum, particularly in non-recurrent cases.
