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You must know and remember that anal fistula is a condition which has got fairly high recurrence rate, meaning it has a tendency to occur again after the operation. Complete cure is very difficult. I strongly suspect that you have got fistula-in-ano again. Please consult your treating surgeon for the same. There can also be some conditions in which there is a high rate of recurrence of fistula if not treated primarily such as tuberculosis, Crohn's disease, malignancy, etc. You can ask your doctor regarding the same.
The Probable causes:
1.Failure of operative treatment.Investigations to be done:
2.Underlying secondary causes.
1.MRI fistulogram.Differential diagnosis:
2.Investigations for suspected secondary causes.
1.Recurrent fistula-in-ano.Treatment plan:
1.Investigate the fistula.Preventive measures:
2.Rule out secondary causes.
3.Treat the underlying secondary cause if any.
4.Operate if fistula persists.
1.Maintain anal hygiene.Regarding follow up:
2.Regular sitz bath.
For more information consult a general surgeon online.--->https://www.icliniq.com/ask-a-doctor-online/general-surgeon