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CC BY 4.0 · Journal of Coloproctology 2025; 45(03): s00451810614
DOI: 10.1055/s-0045-1810614
Original Article

Healing Beyond the Wound: Impact of Surgery on Quality of Life and Sexual Well-Being in Patients with Cryptoglandular Anal Fistula

Authors

  • Tamada Divya Murty 

    1   Department of Surgery, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, Madhya Pradesh, India

  • Dileep Singh Thakur 

    1   Department of Surgery, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, Madhya Pradesh, India

  • Amrendra Verma 

    2   Department of Emergency Medicine, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, Madhya Pradesh, India

  • Uday Somashekar 

    1   Department of Surgery, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, Madhya Pradesh, India

  • Deepti Bala Sharma 

    1   Department of Surgery, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, Madhya Pradesh, India

  • Dhananjaya Sharma 

    1   Department of Surgery, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, Madhya Pradesh, India

Funding The author(s) received no financial support for the research.
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Abstract

Introduction

Cryptoglandular anal fistulas significantly impair patients' quality of life (QOL) and sexual well-being. This prospective study evaluates the impact of surgery on QOL and sexual function.

Materials and Methods Fifty consecutive patients (42 males, 8 females) underwent preoperative MRI-based classification to guide tailored surgery. QOL scores, sexual QOL scores, and incontinence scores were recorded preoperatively and during follow-up. Surgeries included fistulotomy and fistulectomy with or without primary sphincteroplasty. Statistical analysis employed paired t-tests and McNemar's test.

Results

52% had simple, and 48% had complex fistulas. By 8 weeks, 100% of patients reported “very good” QOL (p = 0.02), up from 32% preoperatively. Sexual QOL significantly improved in males (mean score from 42.07 ± 2.64 to 48.14 ± 2.68; p < 0.001), with a non-significant trend in females (22.12 ± 2.75 to 23.75 ± 2.66; p = 0.47). Continence scores reached 0 (i.e., best) by 8 weeks in all patients.

Conclusion

Surgical intervention for cryptoglandular fistula-in-ano significantly improves both general quality of life and sexual health, while preserving continence.

Keywords

anal fistula - cryptoglandular fistula - quality of life - sexual health - incontinence - fistulotomy - fistulectomy

Authors' Contributions

All authors have equally contributed in study design, data collection and analysis, and article writing and proofreading.




Publication History

Received: 02 May 2025

Accepted: 16 July 2025

Article published online:
27 August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Tamada Divya Murty, Dileep Singh Thakur, Amrendra Verma, Uday Somashekar, Deepti Bala Sharma, Dhananjaya Sharma. Healing Beyond the Wound: Impact of Surgery on Quality of Life and Sexual Well-Being in Patients with Cryptoglandular Anal Fistula. Journal of Coloproctology 2025; 45: s00451810614.
DOI: 10.1055/s-0045-1810614