The published study highlights an important gap in current practice. While MRI remains the gold standard for postoperative evaluation due to its high sensitivity and specificity, its cost and limited availability in some regions may limit routine use. In this context, the development of a Jabalpur Transperineal Ultrasonography-Based Scoring System (J-TPUSS) represents a pragmatic attempt to bridge this disparity. However, several methodological and interpretative concerns merit consideration, which we have discussed in the letter.
ThakurDSMishraRVermaA, et al.A transperineal ultrasound-based scoring system (J-TPUSS) for predicting healing after cryptoglandular fistula surgery in resource-limited settings. Trop Doct2026: 494755261429667. 20260314. DOI: 10.1177/00494755261429667
2.
ChineneBMudadiLSMutasaFE,et al.A survey of magnetic resonance imaging (MRI) availability and cost in Zimbabwe: implications and strategies for improvement. J Med Imaging Radiat Sci2025; 56: 101819. 20241216.
3.
GargPYagnikVDDawkaS, et al.A novel MRI and clinical-based scoring system to assess post-surgery healing and to predict long-term healing in cryptoglandular anal fistulas. Clin Exp Gastroenterol2022; 15: 27–40. 2022/02/26.
4.
TeymouriAKeshvariAAshjaeiA, et al.Predictors of outcome in cryptoglandular anal fistula according to magnetic resonance imaging: a systematic review. Health Sci Rep2023; 6: e1354. 20230622.
5.
DawkaSYagnikVDKaurB, et al.Garg scoring system to predict long-term healing in cryptoglandular anal fistulas: a prospective validation study. Ann Coloproctol2024; 40: 490–497. 20221011.