Ideal investigation for fistula-in-ano is

CLINICAL ASSESSMENT A full medical history and Proctosigmoidoscopy are necessary to gain information about sphincter strength and to exclude associated conditions. Full examination under anesthesia should be repeated before surgical intervention. Diluted hydrogen peroxide, instilled the external opening, is a very useful way of demonstrating the site of the internal opening MRI is the 'gold standard' for fistula imaging Usually reserved for difficult recurrent cases Advantage of MRI: Its ability to demonstrate secondary extensions Fistulography and CT : Useful techniques if an extrasphincteric fistula is suspected. TREATMENT Treatment options: Fistulotomy, Fistulectomy, Setons, Advancement flaps and Glues Laying open is the surest method of eradication, but sphincter division may result in incontinence