Integrative approach in the management of anterior anal fistula with scrotal extension – A single case report

Fistula in ano has always been a surgical challenge for the surgeon due to the high recurrence rate. This case report depicts the successful management of anterior scrotal-based fistula through an integrative approach. A forty-four-year-old male patient presented with perianal swelling and intermittent discharge from ano for 3 years. The patient had a history of failed surgical procedures to cure his fistula in ano. Based on clinical as well as transrectal ultrasonography he was diagnosed with a low type of inter- sphincteric long anterior scrotal-based fistula. The patient was operated on with partial fistulectomy along with Apamarg Ksharsutra ligation. The post-operative wound was managed with an integrative approach. After eight weeks of a holistic approach, the post- operative fistulous wound completely healed with no recurrence noted within 1.5 years. Integrative management gives a promising outcome in a scrotal-based anterior anal fistula.