A hard lump between the anus and the testicles

The presence of a lump between the anus and testicles is mainly due to symptoms of rectal nodules or anal fistulas. It is recommended that patients should check the cause of the disease and then undergo surgery to remove it. When a lump appears between the anus and the testicles, it will affect anal defecation and cause poisoning. Therefore, for such serious symptoms, it is best to perform minimally invasive surgery to reduce postoperative care problems.

This is most likely a symptom of an anal fistula.

Anal fistula is the abbreviation of anorectal fistula, which is a sequelae of abscess rupture or incision drainage around the anorectum. Anal fistula is the post-abscess stage, two stages of a disease. The English name is Anal fistula, and it is called anal leakage in traditional Chinese medicine. A typical anal fistula is a clear, complete tube with one end in the anal sinus and the other end outside the anal margin or in the rectal wall. Atypical anal fistula usually has only an internal opening but no external opening, or has both an internal and external opening but the middle fistula tract is blocked, or has only an external opening and the internal opening cannot be found, or there is simply a hard lump.

Classification

Anal fistulas are complex and need to be further subdivided. Many classification schemes have been proposed from various perspectives at home and abroad. Here we introduce the most commonly used classification method in clinical practice.

1. High and low

In 1934, Millgan and Morgan of S.mark Hospital in the UK used the tooth line as the dividing line. This classification is simple and clear, and very practical. The dentate line is the dividing line between the anus and the rectum and can be clearly seen under an anoscope. The anal sinus at the dentate line is the internal opening of the infection of anal fistula. Taking this line as the starting point, upward is high-position anal fistula, and downward is low-position anal fistula.

In 1975, the domestic anorectal community held the first national anorectal conference in the country's history in Hengshui City, Hebei Province. At this conference, it was determined that the deep part of the external anal sphincter was the dividing line between the high and low positions.

2. Single fistula or multiple fistulas

Counting the external openings or fistulas, if there is only one, it is called a simple anal fistula. If there are multiple, it is called a complex anal fistula. However, some fistulas are too long or curved, which can be clinically called complex anal fistulas. Complex anal fistula sometimes has a single internal opening and sometimes has multiple internal openings. This needs to be distinguished because the clinical treatments are different. This classification method was proposed by Chinese scholars at the Hengshui Anorectal Conference in 1975 and is currently widely used in clinical practice.

3. Subcutaneous and submucosal

Most anal fistulas cross the anal sphincter, but subcutaneous submucosal anal fistulas are an exception. These are the two most superficial types of anal fistulas, which are basically located on the inner side of the sphincter. A subcutaneous fistula is located under the skin at the anus margin and may occur anywhere around the anus margin. It is very close to the anal margin, generally no more than 5 cm, and the internal opening is located at the tooth line corresponding to the external opening. A submucosal anal fistula is located under the rectal mucosa, and the internal opening is located at the same point as the tooth line.