During the cold season, the incidence of perianal abscesses increases dramatically. Every fall and winter, about 10-15% of hospitalized patients suffer from this disease. This disease is characterized by a rapid onset, rapid development and great pain. For example, hemorrhoids are a chronic disease, so it doesn’t matter if you delay for a year and a half after discovery. But perianal abscess is different, once the attack is very painful, just two or three days, the anus is first painful, then swollen, people sit and sleep. Soon, the inflammatory mass will cause a fever, and in severe cases even develop into a high fever within a short period of time. These are very painful and can cause a rush to the hospital. Surgery is the only way to cure it; conservative treatment is prone to recurrence Perianal abscesses cannot be prevented and are acute once they flare up. In the clinic, most use infusions to reduce inflammation first. I have met many patients who have expressed the question, can it be treated conservatively? An infusion, medication, or injection is all that is needed. Dear readers, I am sorry to tell you that most cases of perianal abscess can only be cured by surgery. This is because once the pus is formed, it is difficult to eliminate it completely by infusion. Traditional treatment requires two surgeries Traditional treatment of perianal abscesses requires two surgeries. The first one is “abscess incision and drainage”, which is to cut a small opening in the perianal abscess and drain the pus out, and once the inflammation is controlled, symptoms such as fever and pain will be immediately relieved or even eliminated. Many people think that this is good enough. Actually, it is not. The infected internal opening at the end of the rectum still exists, so the abscess may not have grown completely and pus will still flow out. Moreover, changing medication and taking sitz baths do not solve the problem. You will find that the surgical incision is broken and pus flows, especially after drinking and eating chili, and the attacks are more frequent. In case of acute infection, local abscess and unbearable pain will suddenly occur. The pus often flows from the small incision, and over time, the pus cavity slowly shrinks to the middle, forming something like a pipe, a “fistula”. The doctor can feel a hard, tube-like object through the fingertips during a review. This creates a complete fistula and means that a second surgery is needed – a radical fistula incision. Today, in order to avoid having to undergo two surgeries and to shorten the treatment process, the medical community advocates “one root” treatment. In the first operation, the primary internal opening of the perianal abscess is accurately identified and treated directly to avoid the formation of a second fistula. So, why did we have to use two surgeries in the past? In the past, technology and experience were limited, and it was difficult to accurately identify the internal orifice of the attack during the acute attack. There are many interstitial spaces around the anus, and abscesses can occur in all of them. Simply by location, there are deep ones and superficial ones (closer to the anal opening); deep post-anal interstitial abscess, post-rectal interstitial abscess, and many other kinds. It is quite difficult to find all of them accurately at the time of inflammation. Finding the wrong one or missing one means that a second surgery is needed. In contrast, when an anal fistula is formed, the internal opening is more typical and easy to distinguish accurately. Therefore, in the past, the medical community preferred to make another incision to eradicate the fistula after a few months, when it formed. When a lot of experience has been gained and advanced and accurate instruments and equipment are available, it is possible to accurately find the internal orifice at the early stage of the abscess. The one-time radical surgery does not take too long, depending on the condition, and can be completed in about 20 minutes for simple cases or more than an hour for complicated ones. Afterwards, hospitalization is required to change the medication for about 3 days to a week. Not only does it shorten the treatment cycle, but it also prevents the patient from having to endure the pain of two surgeries, which can be considered a humane and good method.