Laser treatment for anal fistula – Anal fistulas can be painful, persistent, and often deeply disruptive to quality of life. Traditionally, surgical options have come with risks to continence. However, over the last decade, laser-assisted procedures have emerged as a game-changer—offering a minimally invasive, sphincter-preserving approach.
In this post, I’ll explore how laser therapy, particularly the FiLaC™ technique, is reshaping how we treat anal fistulas.
What Is an Anal Fistula?
An anal fistula is an abnormal tunnel between the anal canal and the skin around the anus. Most commonly, it develops after an anorectal abscess doesn’t heal completely. Patients often experience symptoms such as:
- Pain or swelling near the anus
- Smelly or bloody discharge
- Itching (pruritus ani)
- Difficulty controlling bowel movements
Men are more likely than women to develop fistulas, especially between the ages of 20 and 60. In fact, the condition affects about 12.3 men and 5.6 women per 100,000 people annually.
Why Are Fistulas So Difficult to Treat?
The main challenge in treating anal fistulas is eradicating the entire fistula tract while preserving the surrounding sphincter muscles. Traditional methods like fistulotomy, seton placement, and fistula plugs can be effective but often carry risks of incontinence or recurrence—especially in complex cases.
This is where newer techniques, such as laser fistula closure, are changing the game.
How Does laser treatment for anal fistula Work?
The FiLaC™ (Fistula Laser Closure) procedure uses a radial-emitting laser probe to gently seal the fistula tract from within. By delivering energy precisely, it destroys the fistula lining without cutting through muscle. Most importantly, the technique preserves the anal sphincter—significantly reducing the risk of incontinence.
Here’s how it typically works:
- A thin laser fiber is inserted into the fistula tract.
- Controlled laser energy (at 1470 nm wavelength) is applied while slowly withdrawing the fiber.
- The laser collapses and seals the tract, and the internal opening is closed using a flap or sutures.
What Do the Studies Say?
Multiple clinical studies have reported promising results:
- Giamundo et al. achieved a 71% success rate with no incontinence.
- Oztürk and Gülcü found an 82% success rate over a 12-month follow-up.
- Donmez et al. reported an 89% healing rate in their retrospective review.
- Most studies also noted recurrence rates of less than 6%.
However, not all results have been equally positive. A few trials have shown success rates as low as 22%, with researchers attributing the variability to factors like:
- Fistula length
- Laser energy dosage
- Incomplete closure of the internal opening
Despite this, the vast majority of patients experience significant relief, minimal downtime, and preserved continence.
Is Laser Right for You?
Laser treatment is particularly beneficial for patients with:
- Transsphincteric or intersphincteric fistulas
- High or complex tracts where traditional surgery may threaten continence
- Recurrent fistulas or failed previous surgeries
However, as with any treatment, results can vary. Fistula anatomy, previous surgeries, and general health all play a role in determining success.
Are There Any Side Effects?
The procedure is generally well-tolerated, but some patients may experience:
- Temporary discomfort or mild pain
- Low-grade fever
- In rare cases, recurrence or minor soiling
Most people return to normal activities within a few days.
Final Thoughts
The role of lasers in anal fistula management is promising. While not a cure-all, laser procedures like FiLaC™ offer a highly effective, low-risk alternative to traditional surgeries—especially for complex or recurrent cases.
If you’re struggling with a chronic anal fistula and want to explore advanced treatment options, a personalized evaluation can help determine whether laser therapy is the right solution for you.
Want to know if you’re a candidate for laser fistula repair?
📞 Book a consultation with Dr. Sajeet Nayar today.