Can lis cut turn into fissure.

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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Can lis cut turn into fissure.

Postby delasama » 07 Feb 2013, 18:55

Lis sounds so aggressive. I don't understand how they cut sphincter and expect it to heal if the fissure won't heal either.i understand it allows fissure to heal but wouldn't the lis cut keep stretching also and not heal??? I've heard stories on here about lis cut not healing.
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Re: Can lis cut turn into fissure.

Postby delasama » 07 Feb 2013, 18:58

I have an appointment with crs in a month! I have no insurance though. He told me to take miralax and Metamucil until I see him. I wonder if he will do a colonoscopy.
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Re: Can lis cut turn into fissure.

Postby Chelle16 » 07 Feb 2013, 19:35

Hello,
So sorry that you're still dealing with this horrid thing! I wish you luck with your appointment with the CRS. I also put off seeing a surgeon for my AF, but after 3 months of hellish pain for 24 hours I was quickly spiralling into depression and my Mum (!!) actually dragged me to the doctors (more or less).
I had LIS 2 and 1/2 months ago - I was scared like you, but I had lost all hope of having a normal life, I couldn't even enjoy my brand new 6 week old baby! I have slowly started to improve, however only in the last 5 days can I now say that I am comfortable for the majority of the day.
One of the reaons an AF does not heal is because the internal anal sphincter is in spasm (from the pain of the AF). This spasm constricts the blood vessels supplying the anal skin where the AF is - and you need a healthy blood supply to help heal wounds, to bring nutirents, oxygen etc to the area. Over time, with continued spasm - there is lack of blood supply and the wound cannot heal. Sometime the tissue around the fissure even looks white, instead of a nice healthy pink colour.
This is why they make a small incision in the internal anal sphincter (LIS) - to help it to relax, to increase the blood supply to the anal skin and help relieve some pain. The incision in the sphincter heals because (usually) this muscle is healthy tissue with an adequate blood supply and scar tissue forms over the edges.
I was fortunate that I did not develop permanent faecal incontinance after the surgery. I did have trouble controlling gas and some stool if I was not right near a toilet - but this only lasted a couple of weeks.
Good luck!
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Re: Can lis cut turn into fissure.

Postby delasama » 08 Feb 2013, 14:03

Wow!thankyou. I can't believe your almost three months post op and still not completely comfortable. I hope you fully heal soon
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Re: Can lis cut turn into fissure.

Postby Davo » 11 Feb 2013, 08:52

Hi,
Just to answer your original question.
The LIS cut is made just on the outside of the anus rather than on the inside where the fissure is. The sphincter muscle is then slightly pulled out, a small cut is made exactly the same length as the fissure and the muscle is put back in.
The whole process takes about 2 minutes and is not aggressive at all.
This then allows relaxation at the point of the fissure to allow healing.
The sphincter then gradually returns to about 80% of its original strength within about a year
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Re: Can lis cut turn into fissure.

Postby delasama » 11 Feb 2013, 21:04

Thanks Davo . That was what I needed to know.
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Re: Can lis cut turn into fissure.

Postby aimonaali » 12 Feb 2013, 13:39

LIS isn't always made on the outside. Mine is on the inside of my anus.
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Re: Can lis cut turn into fissure.

Postby Davo » 12 Feb 2013, 14:59

Hi aimonaali?
The LIS cut should be made on the external edge of the anus - it would be very difficult (if not imposdible) for a surgeon to operate on the inside as there would be little room to manoeuvre and he would doing the surgery blind.
The cut may seem internal as it is not visible unless you part the buttocks.
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Re: Can lis cut turn into fissure.

Postby aimonaali » 15 Feb 2013, 10:36

Davo wrote:Hi aimonaali?
The LIS cut should be made on the external edge of the anus - it would be very difficult (if not imposdible) for a surgeon to operate on the inside as there would be little room to manoeuvre and he would doing the surgery blind.
The cut may seem internal as it is not visible unless you part the buttocks.
Davo

Apparently there are more than one ways to do LIS:) Mine is definetely on the inside, about an inch from the "opening". The surgeon used a special device to open my anus before cutting the inner sphincter. I can still feel the wound, the fissure itself has healed quite well.
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Re: Can lis cut turn into fissure.

Postby jr2 » 15 Feb 2013, 10:51

There are two different ways of performing LIS. The open method and the closed method, and it just depends on the surgeon and how he/she was trained as to which method will be performed.
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