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Vakul Aren
Vakul Aren, Doctor
Category: Health
Satisfied Customers: 4106
Experience:  MBBS,DTM&H( Univ of Liverpool),34yrs experience in practice
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I have a Fistula Under the Testicles and on the front of

Resolved Question:

I have a Fistula Under the Testicles and on the front of Anus. Recently I had a colonoscopy and the doctor mentioned everything is fine and The fistula is also not connected t the inside and it is only on the Top. The doctor mentioned that a Surgical Procedure is also not needed for the Fistula and Drained it.
However i notice some blood drainage sometimes and some discomfort the fistula gets normal.
Recently it got little worse and the whole area near the fistula became red, swollen and got painful. The Doctor advised some antibiotics and the Bacteria Culture test came back as positive Strep B group, But on the using the antibiotics all the issues were healing and i am feeling much better for few days and i am still on the antibiotics course, However suddenly i am feeling little discomfort today and feel the redness,swelling is comming back.
What is causing this?
Submitted: 6 years ago.
Category: Health
Expert:  Vakul Aren replied 6 years ago.
Dear customer,
Welcome to Just Answer.A fistula in the perineum would be secondary to Crohns disease or Inflammatory bowel Disease,due to a anorectal fistula/abscess,trauma to the crotch/saddle area,secondary to Lymphogranuloma Venereum or tuberculosis,local testicular abscess or other infections like perineal abscess.Since you are currently having a infection in the perineal area,it would be prudent to investigate the cause by a CT scan to identify the extent of the abscess/infection in the tissues.Antibiotics as advised after a culture and sensitivity should clear the area unless there is a deeper abscess .Since treatment by antibiotics alone does not seem to be clearing up the problem ,a surgical intervention to clear the underlying cause and excision of the fistula tract may be needed.You may need a surgical opinion and further investigation as to the root cause of the problem to adequately treat the fistula.Repeated infection in this area should be avoided .
Customer: replied 6 years ago.

Thanks doctor for the Advise,

I consulted a colo-rectal surgeon and he performed the colonoscopy and looked at the fistula and mentioned the fistula is not deep and is existing only on the Top.

I am seeing another surgeon soon referred by the earlier surgeon.

However my concern is if anything malignant is causing this, if it is during a colonscopy would it not been found?

Expert:  Vakul Aren replied 6 years ago.
A fistula is a track from the deeper layers to the surface of the skin,so it is unlikely that the cause of the fistula would be on top.Fistulas may occasionally be secondary to malignancy,but more commonly inflammatory bowel disease,infections from the perianal area are the common sources.The use of a MRI/CT scan will be able to identify the starting point of the fistula and subsequent tests may help identify the cause exactly.A infective origin is more likely.
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