A perianal abscess is a pus collection causing severe pain and requiring urgent incision and drainage. Decompression brings immediate relief; in a proportion of patients the abscess may later develop into a fistula.
What does it involve?
The operation opens and drains the pus collection, decompressing the area. It is the immediate, definitive treatment of the acute phase; antibiotics alone are not enough.
When is it needed?
It is indicated urgently for any perianal abscess — severe, throbbing pain, swelling, redness, often fever. Delay worsens the infection.
Preparation
As an emergency, it is preceded by immediate proctological assessment and brief preparation. It is done under anaesthesia for adequate, painless drainage.
How it's done
Under anaesthesia, an incision is made over the collection and the pus is drained. The cavity is cleaned and left to heal. Where a fistula is found at the same time, its treatment is often planned at a second stage to protect the sphincter.
Incision & drainage
Urgent decompression of the collection under anaesthesia — immediate relief.
Local healing
Sitz baths, dressings and monitoring of the cavity until healing.
Check for fistula
Follow-up and, where needed, planned treatment of a fistula.
Recovery
Pain relief is immediate. Local care with sitz baths and dressings follows, with discharge usually the same day. Follow-up is needed for a possible fistula.
Risks & outcomes
A simple, safe operation with an immediate result. In a proportion of patients a fistula subsequently develops, treated separately. The abscess may recur if an untreated fistula coexists.
Frequently asked questions
Are antibiotics enough?
No. An abscess is a pus collection that needs incision and drainage; antibiotics are adjunctive and do not replace drainage.
Will I develop a fistula?
In a proportion of patients the abscess progresses to a fistula. That is why follow-up is needed; if it appears, it is treated separately with sphincter-preserving techniques.
How quick is the relief?
Decompression brings immediate pain relief, usually from the first day.
Will I stay in hospital?
In most cases it is done as a day case.