Healing rates following sphincter-sparing repairs of cryptoglandular anal fistulas are modest, but have improved over time with the use of better surgical techniques. In this study, ligation of the intersphincteric fistula tract and flaps were superior to fistula plugs and fibrin glue; the former procedures are therefore favored. See Video Abstract at http://links.lww.com/DCR/A391.

Male genitourinary function can be severely affected after pelvic surgery-even when performed for benign disease. Sympathetic and parasympathetic nerves instrumental to normally functioning neural pathways can be located in close proximity to left colon and rectal structures.• Many questionnaires are available to measure male genitourinary function. None are perfect and choosing the best tool depends on the outcome being studied. • Radiotherapy and to some degree chemotherapy both can have detrimental effects on male genitourinary function. • Selecting interventions to improve quality of life dependson compassionate questioning and building a rapport with the patient. This ideally should begin before starting treatment. • Sexual function and dysfunction after surgery in LGBTQ patients is often ignored by caregivers and poorly studied. This group of patients can experience unique quality of life problems after pelvic surgery, and awareness is the first step to studying and understanding their needs.

Pruritus ani is a benign anorectal disorder characterized by an itching sensation of the perianal skin. It is a source of embarrassment and frustration for those who suffer from it. Multiple conditions can be responsible for perianal itching; however, most cases are idiopathic. Skin breakdown from constant scratching creates a vicious cycle exacerbating the symptoms. Empiric treatment resolves the problem in most cases, but additional testing should be performed when deemed necessary. Guided management to control associated diseases, lifestyle modifications, as well as skin protection, is paramount in the management.

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