Additionally, recurrent abscesses may lead to significant short term morbidity from pain and, importantly, create a starting point for systemic infection.

Possible findings: Depending on their relationship with the internal and external sphincter muscles, fistulae are classified into five types: Other conditions in which infected perianal "holes" or openings may include pilonidal cyst.

Treatment depends on where the fistula lies, and which parts of the internal and external anal sphincters it crosses.

However, treatment is challenging as complete eradication of the anal sphincters may lead to continence impairment, but failure to excise the affected areas results in recurrence.

Before the procedure, the patient is given a spinal or general anaesthetic and is placed in the lithotomy position (legs in stirrups with the perineum at the edge of the table).

In the diagnostic phase, the fistuloscope is inserted into the fistula to locate the internal opening in the anus and to identify any secondary tracts or abscess cavities.

The anal canal is held open using a speculum and irrigation solution is used to give a clear view of the fistula tract.