An anal fistula is a condition in which an abnormal small tunnel forms between the inside of the anus and the surrounding skin. This problem typically develops from an infection that progresses into an abscess and does not heal completely. Common symptoms include pain around the anus, discharge of pus or foul-smelling fluid, skin irritation, and the presence of a painful lump that may worsen when sitting or during activity. If not treated properly, an anal fistula can cause recurrent infections and significantly impact a patient’s quality of life.
At Mandaya Royal Hospital Puri, anal fistula treatment is handled by a dedicated team of specialists consisting of experienced general surgeons and digestive surgeons who are skilled in managing anorectal conditions. Supported by advanced medical technology and a comprehensive care approach, the team ensures accurate diagnosis, appropriate treatment options, and safe surgical procedures. This multidisciplinary approach helps optimize treatment outcomes and minimize the risk of recurrence.
Contents
Anal Fistula Treatment at Mandaya Royal Hospital Puri
Treatment for anal fistula depends on its location, complexity, and underlying cause. The goal of therapy is to completely repair the fistula while preserving the function of the sphincter muscle. Damage to this muscle can lead to fecal incontinence. Although surgery is typically required, non-surgical approaches may be considered in selected cases.
Surgical treatment options include:
1. Fistulotomy
The surgeon opens the internal tract of the fistula, removes infected tissue, flattens the channel, and stitches it so it remains open during healing. For more complex fistulas, part of the tract may need to be removed. Fistulotomy may be performed in two stages if a large portion of the sphincter muscle is involved or if the entire tract cannot be identified in a single procedure.
2. Endorectal advancement flap
In this technique, the surgeon creates a flap from the rectal wall before removing and closing the internal opening of the fistula. The flap is then used to cover the repaired area. This method reduces the amount of sphincter muscle that needs to be cut.
3. Ligation of the intersphincteric fistula tract (LIFT)
The LIFT procedure is a two-step technique used for deep or complex fistulas. This method allows the surgeon to access the fistula between the sphincter muscles without cutting them. In the first stage, a seton thread (silk or latex) is placed inside the tract to gradually widen it. A few weeks later, the surgeon removes the infected tissue and closes the internal opening.
For very complex anal fistulas, more invasive procedures may be needed, such as:
- Ostomy and stoma: The surgeon creates a temporary opening in the abdominal wall to divert stool away from the anal canal. Waste is collected in an external pouch, giving the affected area time to heal.
- Muscle flap: For extremely complicated cases, the fistula tract may be filled with healthy muscle tissue taken from the thigh, labia, or buttocks.
General and Digestive Surgeons at Mandaya Royal Hospital Puri
Below are the general surgeons and digestive surgeons at Mandaya Royal Hospital Puri who manage anal fistula cases:
1. dr. Erwin Suryanegara, Sp.B, MSI.Med
dr. Erwin Suryanegara, Sp.B, MSI.Med is a general surgeon with extensive experience in treating various anorectal disorders, including anal fistulas. He completed his surgical residency at Diponegoro University and earned a Master’s degree in Biomedical Sciences. He has also participated in numerous trainings such as Basic–Advanced Laparoscopic programs and anorectal surgical techniques. With a thorough and meticulous approach, he is committed to providing safe and effective treatment for patients with anal fistula.
Practice schedule:
- Monday: 08.00 – 12.00 WIB
- Tuesday: 08.00 – 12.00 WIB
- Thursday: 08.00 – 12.00 WIB
2. dr. Ocsyavina, Sp.B, Subsp.BD(K)
As a digestive surgeon, dr. Ocsyavina, Sp.B, Subsp.BD(K) has deep expertise in managing gastrointestinal conditions, including advanced anal fistula cases. She completed her medical education at Universitas Padjadjaran and her surgical residency at Universitas Indonesia. With extensive experience, she prioritizes patient safety, precision, and preservation of sphincter function in every procedure.
Practice schedule:
- Monday: 16.00 – 18.00 WIB
- Tuesday: 16.00 – 18.00 WIB
- Wednesday: 16.00 – 18.00 WIB
- Thursday: 16.00 – 18.00 WIB
- Friday: 16.00 – 18.00 WIB
- Saturday: 10.00 – 12.00 WIB
3. dr. Tiur Herlina Juliana, Sp.B
dr. Tiur Herlina J, Sp.B is a surgeon experienced in treating anorectal disorders, including anal fistulas. She graduated from Universitas Padjadjaran and is active in professional organizations such as the Indonesian Medical Association and the Indonesian Surgical Association. Her expertise includes modern treatment options, including minimally invasive laser procedures.
Practice schedule:
- Monday: 16.00 – 19.00 WIB
- Wednesday: 17.00 – 20.00 WIB
- Thursday: 16.00 – 19.00 WIB
- Saturday: 13.00 – 16.00 WIB
4. dr. Tjhin Sun Fu, Sp.B, M.Biomed
dr. Tjhin Sun Fu, Sp.B, M.Biomed is a general surgeon skilled in minimally invasive procedures, including anal fistula surgery. He completed his medical education at Universitas Padjadjaran, pursued Biomedical Sciences, and attended various surgical trainings such as the Hernia Essential Training Course and laparoscopic surgery programs. His expertise ensures precise, safe, and comfortable treatment for patients.
Practice schedule:
-
Monday–Saturday: 08.00 – 20.00 WIB
5. dr. Emerson Budiarman Masli, Sp.B, Subsp.BD(K)
dr. Emerson Budiarman Masli, Sp.B, Subsp.BD(K) is a digestive surgeon experienced in managing a wide range of gastrointestinal conditions, including anal fistulas requiring reconstructive treatment. As a member of the Indonesian Medical Association and the Indonesian Surgical Association, he provides care based on the latest medical standards, ensuring safe, evidence-based, and effective treatment.
Practice schedule:
- Monday: 10.00 – 13.00 WIB
- Wednesday: 10.00 – 13.00 WIB
To simplify your visit to Mandaya Royal Hospital Puri and receive proper treatment for an anal fistula, you can use the WhatsApp Chat feature, the Book Appointment service, or the Care Dokter application—available on Google Play and the App Store—to view queue numbers, schedule visits, and access complete information.
