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

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