A large study on lifestyle factors increasing probability of fistula and factors responsible for recurrent fistula

Background: Fistula-in-ano (FIA) commonly affects males more than females. Some differences in the characteristics of FIA between both genders have been recognized, yet the impact of these differences on the outcomes of surgery for FIA is still unclear. The present study conducted a gender-specific analysis aiming to assess the characteristics and the outcomes of surgery of FIA in each gender. Methodology: The records of patients with FIA were retrospectively reviewed and the following variables were extracted: patients' demographics, type of FIA, the position of the external opening, the operation performed, the incidence of recurrence, and complications, particularly fecal incontinence (FI). Gender-based analysis of the characters and outcomes of surgery for FIA was performed. Results: When a detailed case study was done, most patients having abscess with fistula were either on long-term medication (prolonged use of antibiotics) or immunocompromised. Out of 11.4% of cases of recurrent fistula, 34% were diabetics and 2.4% were HIV reactive, 18.76% were tubercular. Conclusion: The majority of FIA in males were posterior and high trans-sphincteric, whereas most FIA in females were low and anteriorly based. Despite the different characteristics of FIA; no statistically significant differences in the rates of fistula recurrence and FI between males and females could be recorded.