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Anal fistula plug is a minimally invasive and sphincter-preserving alternative to traditional fistula surgery. The plug is a conical device that is placed by being drawn through fistula tract and suturing it in place. The procedure is performed in an outpatient operating room under intravenous sedation and local anesthesia. The plug is placed into the internal anorectal opening and pulled through the tract to the external opening. Most anal fistula patients first develop a peri-anal abscess (mostly from a little infection in the mucous glands in the lining of the anal canal), these patients suddenly wake up with a red painful swelling in the skin surrounding their anus, they cannot sit comfortably, they can feel a little bump in the skin around the anal opening, it hurts if they press it, it is extremely tender, this is. Perianal fistula also commonly called fistula-in-ano, is an abnormal hollow tract or tunnel that is lined with granulation tissue that connects a primary opening inside the anal canal to a secondary opening in the perianal skin secondary tracts may be multiple and can extend from the same primary opening 1) and have significant negative impact on their quality of life 2). An anal fistula is an abnormal tunnel under the skin that connects the anal canal in the colon to the skin of the buttocks. Most anal fistulas form in reaction to an anal gland that has developed an abscess, or a pus-filled infection. There are various different types of surgery for anal fistula see the what happens during surgery section below for full details. All types of surgery for anal fistula aim to get rid of the fistula, while causing as little damage to the sphincter muscles around your anus as possible. Some types of fistulas branch into more than one opening or cross the sphincter muscles that control the sphincter muscles, which control the opening and closing of the anus. The procedure is safe and has very few side effects in fact the main advantage of botox injection is the avoidance of lateral sphincterotomy surgery, which is a permanent division of part of the anal sphincter muscle and a procedure that has a minor risk of incontinence. Anal fissure & anal fistula differences this article was published on october 17, 2013, and was last updated on may 1st, 2019 in hemorrhoid banding. With symptoms like bleeding and pain or itchiness in the rectal area, anal fissures and anal fistulas can be difficult to ignore. The pt reported at this appointment, the doctor confirmed the presence of a fistula and performed a digital rectal exam.