Laser Treatment For Fistula: An Analysis!

Hi, there. Let’s say you are driving to your office, trying to mentally recall all the things that you have already done in the day and the tasks you are supposed to accomplish. During the mind mapping, you realise that you haven’t gone to the bathroom. Big deal. You can take time to go later, right? I mean, it isn’t like your workplace doesn’t have a toilet. So, you are done with your day and heading back home, thinking of dinner, already. Hold on, there’s been a no show from your poop. It’s okay, you can go later.

 It’s been a couple of days now that you haven’t gone to the toilet properly, and as you drive through your usual route to your office, you wonder if you might have a problem in your rear end. Just then, your eye, coincidentally, notices an ad on the road. It’s about laser treatment. Dismissing it as one of those ‘get silky smooth skin’ ads that you don’t care about, you drive on. Even though the ad is gone, your problems with the rear end haven’t. There’s pain, there’s swelling around your anal region and worse still, there is some sort of very foul-smelling fluid oozing out. Oh dear. These are the hallmarks of a pretty nasty problem that’s building down there. You are embarrassed to even talk to anybody about this.

What would they think?

That you are someone with very poor anal hygiene, that you are dirty. You surely don’t want that! So, you do what most people with a smartphone do. You Google. Even before you can figure out what’s happening, the same laser ad is served to you on your screen. You scroll past, trying to understand what could have gone wrong with you. It looks like you have a fistula. Oh no! But then, instead of going to a doctor, you walk into a pharmacy and ask for medicines that Dr Google prescribes. Done deal, you consider, but hey, that might not be the case, actually. As your problem worsens and your whole routine starts falling out of place, you contemplate going to a doctor, but the thought of all those machines popping in and out of your sensitive parts traumatises you. What happens if those treatments render you the slave of an adult diaper? So, you Google again. The same ad appears. “What the hell,” you think to yourself, finally succumbing into clicking it. “Laser treatment for fistula. Painless and quick” Oh, there’s a ray of hope. A painless treatment would be great, right?

Bursting The Bubble Let’s first get down to the finer details. 

The ads that you are shown on your smartphone are curated especially for you. The keywords that you use in your search along with how many times you have used them in the past will determine what ads you see. That said, nobody is denying the effectiveness of laser as a medical tool. It’s a marvellous medical development that’s soon emerging as a doctor’s favourite. But, before you opt for this aggressively advertised treatment type, you need to know several things that are veiled from you and many others.

The Important Factors Before you go for a treatment for fistula, it’s best to first consult with an experienced coloproctologist, because hey, they are the people who know this stuff best. You can’t just walk into a hospital or clinic and say, “I’d like to order one laser treatment for fistula, please.”

It’s a different ballgame here. Your doctor needs to examine you and understand the following things.

1. Is it really a fistula, or some other problem?
    
2. In case it is a fistula, what grade is it in? For the unsuspecting, fistula is a nuisance that also has grades, from one to three, one being the least problematic. Grade one and two can be treated with medications and lifestyle changes, but if you have transitioned to Grade 3, then you need surgical treatment. Doppler Guided HAL RAR. In medical terms, this is a Hemorrhoid Artery Ligation with Recto Anal Repair and this is what a good doctor would recommend. This, in combination with the much-advertised Laser is what is needed to tackle this grade of fistulas.
    
3. Next, of course, is to check what type of fistula you have. Oh yes, apart from Grades, these also come in types - Simple and Complex.
   • Simple Fistula: These can be treated using a technique called Simple Fistulotomy, in which laser is used to open the tract and drain the fluid out. Considering the precise nature of lasers, the cuts are neat, accurate and fast.
   • Complex Fistula: In this case, laser isn’t enough. Considering that the level of challenges are higher, your coloproctologist’s aim will be to save your sphincter muscles - the ones that control the passing of stool. In a botched up surgery, the risk of damage to these muscles is higher, leading to stool incontinence. Therefore, conventional fistula surgery, assisted by laser technology is what should be used.

A Dose Of Reality

The reason behind going into so many details is the fact that as a patient, you deserve to know the truth before you make any healthcare decision. The fact of the matter is - laser treatments alone are not effective for complex and high-grade fistulas. They are great as a tool for a surgery, but they can’t be termed as a treatment in themselves, especially when it comes to fistulas, because their clinical outcomes are not very pleasing. Even though they are very precise and cause minimal tissue burning, in turn minimising blood loss and helping quick recovery, they need to be combined with other procedure to be effective.