Hi,Dear,Welcome with your query to HCM.
Studied your query in full depth of its details.Reviewed it in context of your health concerns.
Based On the facts, You mostly seem to suffer from-
Recurrent
Anal Fistula with High Origin / Type./ or it could be Granulomatous chronic infection like TB / or could be due to accompanied Crohn's disease.
Treatment-
Re-assess the Re-curring Anal Fistula by
Second Opinion from Surgeon and work up the cause for its recurrence before undergoing 4th surgery.
Contrast CT Study of the Fistulogram would give vision and lead to the cause of such recurrent Anal Fistula.
-Any hidden offshoot which is not excised in the last surgery could also cause recurrence, if not worked up thoroughly.
-Treatment for Chronic causes- by anti-Tb medicines could resolve healing of such Anal Fistula.
-
Surgical Treatment by High Fistula Excision,according to the causes would resolve the issues from the experts.
Hope that ,This reply would help you to plan further treatment soon with your treating doctors.Best of Luck and early recovery.
Welcome any further query in this regard,which would be replied in next
session.
Good Day!!
Dr.Savaskar M.N.
Senior Surgical Specialist