Fissure - advancement flap or LIS?

[Dreamer1989]

Hi all,

Has anyone had an advancement flap or Lateral Internal Sphincterotomy for an anal fissure? Ive done all the medical treatment, including two rounds of botox, and I am still not healed, so its on to Surgery. Would really appreciate talking to anyone who has been through the. TIA xx

Bump, anyone? Desperate here.

Old post I know.. but did you have the surgery yet? I've suffered with fissure on and off for 3 yrs. to be honest, it's usually pain free and no issue for 11 months out of the year because I use daily stool softeners but I'm relapsing again now and omjesus it's painful! So done with this!

I am still waiting to see the surgeon, 30th November :( x

How do you manage it daily? Do you use anything to help with the pain and irritation?

I'm about to start Diltiazem for this latest relapse. I used it before when I had a chronic fissue (lasted 4 months after birth of DS) and whether it was that or just time it seemed to heal up enough that it didn't tear each BM. That was 3 years ago. I've had around 3-4 relapses since then but none have been anywhere near as bad as the first chronic one. I'm very consious about nipping them in the bud though, and like I said, I use Laxido daily to keep everything soft. For my relapses previously I've been able to just use some sudocrem or anusol to soothe things whilst I wait it out...but this time seems a bit different sadly so I've gone for Diltizem again.

Sphincterotomy can lead to incontinence issues and is usually avoided in women, especially if there's a chance you will be pregnant and therefore giving birth in future. Intentions to get pregnant or not a sphincterotomy is not something I would agree to for myself, given the risks.

Flap advancement doesn't come with any such issues so is usually first choice. Recovery is not painless but it's not horrific. The first few days will be the worst but it's manageable. You'll be sent home armed with a month's worth of softeners etc. Painwise given what you've already been dealing with I am sure you'll handle it just fine - the psychological advantage is that you know this pain is going to be very temporary and will then go away!

Is the original cause of the fissure resolved? It would be horrible to go through surgery and have it recur. It will be really important after surgery - long term - to make sure you don't get constipated or it could recur, although I appreciate that's not the only cause.

I hope you won't have to wait too much longer once you've seen the surgeon. At least it's on the horizon now.

Oh, also on pain they usually give local anaesthetic as they finish surgery so you won't wake up in immediate pain. And then they'll make sure you have adequate painkillers in recovery and to go home with. You should be able to manage on just paracetamol and ibuprofen (staggered doses) within a few days if not straight away. Things like codeine cause constipation which won't really help!

I dont really have a coping method for the pain, no tablets help. If I am at home, I lay down on the bed until it subsides - if I am at work, I just take a bit longer in the toilet and then sit down back at my desk verrry carefully. Its the most miserable thing I have evee had - if I had the money id go private tomorrow. When its really sore, i use wet tissue paper to try and cool the area, but its not always successful xx

It's just horrific isn't it. I feel uncomfortable many hours of the day and it's difficult to ignore this type of pain - especially when I have to sit at my desk at work for 8+ hours a day.

I had previously seen a specialist who recommended fissureectomy and Botox but I managed to heal myself a month later and didn't fancy the op as I have small DCs. Just praying I can heal myself again this time. Have been using Rectogesic without success for a week or so, but have now got Diltiazem and hoping to see more success with this.

I read a medical study comparing a herbal compound (it was something like aloe Vera, clove oil, leek and something else) against effectiveness of Diltiazem and the herbal compound had amazing results in terms of healing and pain reduction. If only I knew how to make my own compound!

Seeing surgeon tomorrow. I am so worked up and anxious, I will take any operation, I am in just too much pain to cope.

Just home from having the flap, local anasthetic still active all around the area.

Day 2 post op, god its weird. On some lovely painkillers. Would love to speak to anyone else who has had the same
Op.

Hope you feel a lot better soon OP.

Dreamer1989-
I know this is an old post, but I am curious as to how you have healed after your surgery. Was it a success? I am going through the same pain, have been for 16months now and I am just waiting on an appointment with a consultant. I hope you have healed!

Hiya! I am still healing, but so much better. Instead of losing a tablespoon of blood everytime I used the toilet, I lose a couple of spots of blood. Had a post-op phone consult last week, they said the bleeding is expected and it should stop as I heal, it will be 6 months + for full healing.

The recovery was rough, mostly because of the antibiotics. Feel free to DM me if you want to talk anything over.

Hi did u get the surgery??

Yes I had the flap surgery