by Water Bear » 12 Feb 2017, 23:37
Hi everyone, firstly let me say that this forum is a great resource for sufferers of AF!
I should start by saying I'm in Australia, where we have a great health system, and I'm also covered by private insurance so I have not really had to wait very long for treatment.
I developed a fissure shortly after emergency gynaecological surgery around 18 months ago that seemed to have caused some issues with my pelvic floor. The fissure came on slowly, starting with just the slightest tingling after a BM, but after a few months of failing to heal it became deeper and more painful. It was initially misdiagnosed as an external haemorrhoid, so by the time I got the right treatment it had become chronic and started to develop a sentinel tag.
I was referred to a wonderful colorectal surgeon in the middle of last year. She told me to get some GTN ointment from the chemist, which helped my fissure to heal quite quickly and relieved the pain straight away. Unfortunately, my fissure would afterwards recur from time to time for no real reason. I consistently felt the bottom was too tight, even though I have a very high fibre diet and no problems with constipation.
Three days ago I underwent Botox and had small Grade 2 internal haemorrhoids ligated. This was done under general anaesthetic at the same time as a colonoscopy. The worst part was the prep for the colonoscopy, but the doctor wanted to categorically rule out Crohn's disease and ulcerative colitis.
Immediately after my procedure, I had mild urinary retention that was relieved by putting a hot pack against my pelvic floor. I understand this can happen with haemorrhoid banding. I can feel where the needle went in for the Botox, once on each side, but it is not really painful.
The first time I went to the bathroom after the procedure, I very quickly had a lot of pain and a big spasm across my pelvic floor. I nearly fainted from it!
Since then things have become considerably better, perhaps because I have taken paracetamol with codeine each morning a good twenty minutes before going. So far, so good.
It has taken three days for the Botox to relax the sphincter. I feel generally 'looser' down there and it is *so* much easier to have a BM.
Pros and cons? Botox was expensive, at $500 (Australian). It is also not permanent, but I'm hoping it'll buy me some time and maybe help the sphincter 'remember' how to relax. I also think it was important to have the little haemorrhoid treated - it doesn't feel like there's a pillow in the doorway any more! At day three, I'm really quite comfortable except for a little bit of pain with a BM. It's difficult to say whether this is from the Botox or the banding. I'm ready to go back to work.
I realise that I am likely to need the lateral internal sphincterotomy at some stage, but I wanted to try all conservative options before undertaking the surgery. This is mainly because I'm yet to have any babies, and giving birth can cause trauma to all the structures of the pelvic floor, including the anal sphincter - in deciding whether or not to undergo surgery I wanted to consider my lifetime risk of incontinence, not just the risk at this point in my life. If I were to have a baby and the birth caused damage to an already compromised sphincter, I might kick myself...
I hope anyone considering Botox can get something out of my post. All best wishes to you for a speedy recovery from this awful problem!