Found this and thought I'd share.
Explains all the different treatments and their success rates.
GTN , Diltiazem, Botox, fissurectomys, Lateral sphincterotomy (LIS), anal dilation, perennial support devices (toilet seat pressure), Gonyautoxin.
Brings hope.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999245/pdf/WJGS-2-231.pdf
Welsh x