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An anal fistula is an abnormal connection between the lining on the inside of your anal canal (back passage) and the skin near your anus. Most anal fistulas are caused by an abscess (a collection of pus) which has developed in your anal pus can drain away onto the skin on its own or by an operation. Anal fistula (fistula-in-ano) surgery. Information from Bupa on the various types of surgery for anal fistula including recovery and complications.