Botox or LIS? Please advice

Botox or LIS? Please advice

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Botox or LIS? Please advice

Postby kpain » 21 Feb 2014, 13:13

I am almost close to 4 months dealing with my fissure. Last time I checked with CRS, he said it is a superficial fissure with a sentinel pile. I am not seeing any blood lately (touch wood).....but I am unable to get rid of this horrible burning sensation that lasts for 3 to 6 hours depending on BM. I struggle to sit at my desk job or in meetings from morning till noon. I have been trying all kinds of conservative healing methods with diet, nitro and Miralax.....but the burning sensation isn't calming down. My CRS mentioned to try Botox if burning doesn't go away.

I read/heard that Botox has low success rate compared to LIS. Part of me says go with Botox.....but part of me says request for LIS to fix this burning sensation for good. I am concerned with incontinence with Botox and especially LIS but I cannot keep living with this fire in the butt-hole. Can anyone who has done both (botox and LIS) please advice?
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Re: Botox or LIS? Please advice

Postby JHH » 21 Feb 2014, 13:49

Well, if you ask people who has done both, Im not sure you will get the right picture. Afterall, those are people where botox failed to work ;-)

Botox does work, but yes, the success rate is not the greatest. The good thing about botox however, is that its not going to leave you with longterm incontinence, so whats to loose besides a few months. (And in those months most people get painfree even if it fails to heal the fissure)

I was in a similar situation, and chose botox, and now Im happy I did.

Whatever you choose, I wish you the best of luck!

J
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: Botox or LIS? Please advice

Postby kpain » 21 Feb 2014, 14:08

Thanks JHH for the reply. Before Botox, how bad was your fissure and what was your pain level (burning sensation) with this fissure? How soon can one get back to work after getting injected with Botox? Are you now completely pain free with your Botox? Thanks again.
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Re: Botox or LIS? Please advice

Postby vdb324 » 21 Feb 2014, 21:41

The Botox success rate is less (60%-75%; some say 50%). LIS is about 99%, my doctor said.

I did two rounds of Botox. The second round was nearly successful, and then I had a setback, so I am getting LIS done now. I would recommend doing the Botox first, as there are less risks and pain, but we'll see how the LIS goes.
Feb. 2013 - Developed AF
July 2013 - Diagnosed AF;nifidepine lidocaine treatment
Oct. 2013 - 1st round of Botox & skin tag removal
Dec. 2013 - 2nd Botox
March 2014 - Spinchterotomy
June 2015 - Diagnosed with Pelvic Floor Dysfunction/Vulvodynia
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Re: Botox or LIS? Please advice

Postby JHH » 22 Feb 2014, 03:51

Before botox, I had burning for hours after BM. Some days better, some days worse.

The burning was pretty much gone a week after botox. The first four days I was sore, and had troubles moving around. I guess i could have returned to work at day two, but allow a few more days just to make sure.

I had my botox back in june, and yes Im fissurefree and painfree now. Some days I will get some slight soreness/irritation from the scartissue or sentinelpile, but its nothing compared to the fissurepain.

My CRS claimed he heals 3/4 with botox, but I think the real number is about 50-66%

J
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: Botox or LIS? Please advice

Postby vdb324 » 22 Feb 2014, 10:30

I have to agree with JHH on that. Despite not being healed by Botox, it did improve my pain quite a bit. Granted, I am about three months out from my last injection, but the burning and spasms seem to be much less than what they were beforehand. So, it's definitely worth a shot, at the very least for pain management aspect.

The second round had me back at work the next day with no pain. The first round was a bit different, because I had a tag removal done at the same time, which caused quite a bit more pain.
Feb. 2013 - Developed AF
July 2013 - Diagnosed AF;nifidepine lidocaine treatment
Oct. 2013 - 1st round of Botox & skin tag removal
Dec. 2013 - 2nd Botox
March 2014 - Spinchterotomy
June 2015 - Diagnosed with Pelvic Floor Dysfunction/Vulvodynia
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Re: Botox or LIS? Please advice

Postby kpain » 22 Feb 2014, 13:11

Thanks JHH and vdb324 for the advice. It seems logical and besides it doesn't hurt to try Botox before LIS. One more thing I would like to know about the risk of incontinence. The sphincter muscle is relaxed from Botox so how much effect this has on controlling gas or incontinence? Thanks!
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Re: Botox or LIS? Please advice

Postby JHH » 22 Feb 2014, 14:41

I had no issues at all regarding gas or incontinence. I have only read about one single person who had incontinence from botox. I reckon its very uncommon to get these issues from botox.
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: Botox or LIS? Please advice

Postby vdb324 » 23 Feb 2014, 13:27

Botox is much less of a risk in terms of incontinence than LIS. LIS is about 5%, I believe.
Feb. 2013 - Developed AF
July 2013 - Diagnosed AF;nifidepine lidocaine treatment
Oct. 2013 - 1st round of Botox & skin tag removal
Dec. 2013 - 2nd Botox
March 2014 - Spinchterotomy
June 2015 - Diagnosed with Pelvic Floor Dysfunction/Vulvodynia
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Re: Botox or LIS? Please advice

Postby JHH » 23 Feb 2014, 14:22

And with botox its temporary!
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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