Dear Friend Thanks for your query to Healthcare Magic I read your concern about perianal fistula and it seems that surgery is best option for healing a fistula without complications like abscess formation ... Surgery like fistulotomy and recent Laser techniques will allow healing in few weeks and will be safe without affecting spincter muscles .. I would suggest a non surgical procedure called Fibrin glue. The fibrin glue is injected into the fistula to seal the tract. The glue is injected through the opening of the fistula, and the opening is then stitched closed. Fibrin glue may seem an attractive option as it is a simple, safe and painless procedure , but recurrence is noted in some people. You can use medications without surgery but chance for abscess is more eventhough you are in antibiotics . Sitz bath will help to heal by maintaining good circulation of blood . Hope this information is useful, please feel free to ask if you have any queries. Regards Dr.J.Kingson John David