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Questions to ask about fistula surgery

Published 13 March 2026 ·Last reviewed 13 March 2026 by the editorial team ·How we create our content

At a glance

Fistula treatment decisions are more complex than many other colorectal procedures because the type of fistula, its path relative to the sphincter, and the presence or absence of active infection all influence which procedure is most appropriate. Having the right questions prepared helps you understand your options and feel confident in the plan.

About the fistula itself

What type of fistula do I have? Simple or complex? How does it relate to the sphincter muscle?
Has the full tract been mapped? Has imaging (MRI) been done to identify the complete path?
Is there any active abscess that needs to be addressed first?
Is there more than one tract? Complex fistulas with branching tracts may require different approaches.

About the recommended procedure

Which procedure are you recommending and why? Fistulotomy, seton placement, advancement flap, FiLaC, LIFT, or another approach?
Why this procedure over alternatives? What makes it the best option for your specific fistula?
What is the success rate for this procedure with this type of fistula?
What is the recurrence rate? How likely is it that the fistula will come back?
Will this be done in one stage or multiple stages? Some fistulas require staged treatment — a seton first, then definitive surgery.

About continence

This is the question people find hardest to ask but most important to have answered.

What is the risk of incontinence with the recommended procedure?
What type of incontinence — gas, liquid, or solid?
Is the risk temporary or permanent?
Are there sphincter-sparing alternatives if continence preservation is my priority?
How does my specific anatomy affect the continence risk?

About recovery

How long will recovery take realistically? Not the best case — the typical case.
What will the first two weeks look like? Pain levels, wound care, activity limitations.
Will the wound be open or closed? Open wounds (secondary intention) take longer to heal.
What wound care will I need to do at home? Sitz baths, packing changes, gauze.
When can I return to work? Be specific about your type of work.
When can I resume exercise, driving, and normal activities?
What are the signs of complications I should watch for?
When is my first follow-up appointment?

About the surgeon

How many fistula procedures do you perform per year?
What is your personal success rate with this procedure?
Do you have a specialisation in fistula surgery? Some surgeons have a particular focus on complex fistula cases.

Practical questions

Will I need someone to drive me home?
What supplies should I have ready at home?
Should I start stool softeners before the procedure?
What should I eat and drink beforehand?
How long should I plan to take off work?

Writing your questions down

Bring a written list. Appointment time is limited, and anxiety can make it hard to remember what you wanted to ask. If you cannot get through all your questions during the appointment, request a follow-up call or send the remaining questions to the clinic.

Common questions

When should I ask these questions?

Ideally during the consultation where surgery is being discussed. If that appointment felt rushed, request a follow-up appointment or phone call. You can also send questions via the clinic before the procedure. Having answers in advance reduces pre-surgical anxiety significantly.

Is it okay to ask about the surgeon's experience?

Yes. Fistula surgery outcomes are significantly influenced by surgeon experience. Asking how many fistula procedures they perform, what their success and recurrence rates are, and their preferred techniques is entirely reasonable and expected.

What if I do not understand the answers?

Ask for clarification. Medical terminology can be opaque, and your surgeon should be willing to explain in plain language. Bringing a trusted person to the appointment who can take notes or ask follow-up questions is also helpful.

When to seek care Heavy bleeding or feeling faint? Get emergency help now. Emergency: 911

Not sure how urgent it is? Get help today.

Emergency
Heavy bleeding, black tarry stools, feeling faint, severe pain or trouble breathing.

Call 911 or go to the ER.
Today
Fever, pain getting worse, a hot swollen lump, or trouble passing urine.

Call your doctor or go to urgent care.
Soon
Bleeding or bowel changes nobody has checked, or anything lasting 3 weeks.

Book a doctor’s appointment.

Feeling overwhelmed? Call or text 988, any time.

See all the signs

For this topic, get medical advice if you notice:

Increasing pain, swelling, or redness near the anus
Fever or chills
Pus or foul-smelling discharge
New or worsening symptoms while waiting for surgery

Recording how you feel is not the same as being checked. These are the signs that need a doctor’s attention.

Call 911 or go to the emergency room now if you have:

bleeding that will not stop, a lot of blood (the toilet water turns red, or you pass large clots), or any bleeding with feeling faint or dizzy
fainting, a racing heart or trouble breathing
confusion or slurred speech, extreme shivering, no urine in a day, or blotchy skin
sudden severe belly pain, or a swollen, hard belly with vomiting or not passing stool or gas
you cannot pass urine at all, or your bladder feels full and painful and you can’t empty it
redness, swelling or severe pain spreading quickly around your anus, genitals or groin, especially with a fever or feeling very ill
a fever with a painful swelling near your anus if you have diabetes or a weakened immune system (for example, from chemotherapy or transplant medicines)
black, tarry stools

Call your doctor or go to urgent care today (or the ER if you can’t be seen today) if you have:

a temperature of 100.4°F (38°C) or higher, chills, vomiting, or feeling generally unwell
pain that is getting worse over days, or severe pain that stops you sitting or sleeping
a hot, swollen or very tender lump near your anus or at the top of the crease between your buttocks, or foul-smelling discharge
trouble urinating
bleeding that is getting heavier or more frequent, or blood mixed into your stool
feeling much more tired than usual, looking pale, or getting out of breath more easily than you used to
not passing stool for several days, or new belly pain

Make an appointment with your doctor if:

you have never had these symptoms checked by a doctor or nurse — whatever your age
you have had rectal bleeding for more than 3 weeks
your bowel movements have been looser, thinner or more frequent than usual for 3 weeks or more, or you have lost weight without trying
symptoms have not settled after a week or so, or keep coming back
you notice a new lump near your anus, between your buttocks or in your belly, or an itch or discharge that does not clear
you have new leakage or trouble controlling your bowels
you are 45 or over, or have a family history of bowel cancer or inflammatory bowel disease, and any of these symptoms are new for you

If you are unsure, it is always reasonable to ask. If things feel overwhelming, call or text 988 (Suicide & Crisis Lifeline) or chat at 988lifeline.org, any time. If you don’t feel safe, call 911.

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Related symptoms

Bleeding Pain during bowel movements Swelling or lump Discharge

Discreet symptom tracking

Symptoms that come and go? Keep track, day by day.

For hemorrhoids, fissures, fistulas and other anal and rectal problems. A short, discreet email asks how things have been, and saves each answer, so you can look back at every flare and every good week in your own words. If you haven’t had your symptoms checked, see your doctor first.

About ten seconds a check-in. No app, no password.
Nothing in the subject or preview says what it’s about.
Each Sunday, a link to your week, ready for your next appointment.

Start tracking →

Your notes

Your check-in

Takes about ten seconds.

20:00

Example. Nothing on the lock screen hints at symptoms or conditions.

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FiLaC laser treatment for fistula

An overview of FiLaC (fistula laser closure) for anal fistula — how it works, who it may be suitable for, what people describe about recovery.

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Fistula healing journey

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