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What causes a fistula? After an abscess has been drained, a passage may remain between the anal gland and the skin, resulting in a fistula. If the gland does not heal, there will be persistent drainage through this passage. If the outside opening of the fistula heals first, a recurrent abscess may develop.
About 50% of these abscesses may develop into a fistula, in which a small tunnel connects the infected gland inside the anus to an opening on the skin around the anus. What causes an anal fistula? Most fistulas result from an anal abscess.