Anal Fissure, Short height- C-section better?

[php2731]

I am presently 38 week pregnant. I have a history of anal fissure and had
the operation Lateral Internal Spinchterotomy (LIS) done 2 years ago
which is done on Anal spincture muscle. Now I donot suffer from anal
bleeding but often get burning sensation or itching when
constipated etc. I have to take sitz baths occasionally and constantly
have to watch my diet, making sure I take enough fibre and drink enough
water.

So my question is do you think it is reasonable for me to have an elective
c-section to avoid more trauma from labor pushing, tearing etc. to my anal
area? Some women develop anal fissures for the first time during vaginal
childbirth but if I agreed to have a normal delivery, I would be going
into it with a pre-existing injury so to speak. Anyone with fissure problem before delivery and what delivery option did doctor suggest? what was the outcome.

Another concern I have is my short stature of 143 cm. From sonography at
week 36 the weight of my baby was 2796 gm. Doctor said that my pelvic
measurement is ok and i can try for vaginal, but I am not sure if that is
the minimum pelvic measurement. Should this be a concern for me? Anyone with this experience?

Jellycat Sorry for all the questions but was your course of diltiazem long? Were you taking tablets? How long it was before you felt it working?

Many thanks,

php, yes piles are different. I had piles after both labours. I just meant that everything was tender and odd-feeling down there, but I don't think the fissure worsened during the second labour. I think the fissure was caused by the first labour because things never felt right afterwards. It was hard to clean myself properly IYSWIM. But it wasn't till nearly a year later that it got dramatically worse (when I had a bout of diarrhoea). So I can't actually be sure it was caused by the labour...just that my bum has never felt quite right since .

The course of diltiazem was 30 days and it was a cream called Anoheal which I had to insert into my anus [grimace]. IIRC, I noticed an improvement within days but then after that it stayed about the same till the end of the course. I would have carried on till the end of the tube because it felt like it hadn't quite worked, but I was getting an allergic reaction to the cream so I stopped but after that it just got better for some reason (by better I mean it wasn't hurting any more, but it is still there I can feel it and it flares up every now and then..in fact this week it has been quite painful). I don't want to go for the op because it is only occasionally that it hurts and I don't want to risk incontinence later. Also my Mum had a fissure and had the op and it hasn't worked for her. She is on a course of anoheal at the moment, and last time I spoke to her she was noticing an improvement.