Abscesses and fistulas of the anorectum: an analysis of 400 cases.

We must rethink some of our medical training on suppurative disease of the anorectal area because of the complex anatomy of this area. Abscesses should not be left to 'point' before incision and drainage - this often leads to chronic fistula. Fear of causing incontinence by incising the internal sphincter muscle is unwarranted, since continence is maintained primarily by contraction of the external sphincter. Of 400 patients seen in private practice for anorectal disorders, 153 presented with abscess and 248 with fistula. This paper presents the results of treatment and follow-up of these patients.