Yes, it does still spasm. I cannot even imagine them going back in there. Not when my incision is still seeping

The cut for the LIS is very close to the anus. The internal sphincter is closer in than the external and is accessed this way.

I rested a lot for the first month. Have taken it really easy. Don't know what is wrong...I guess I am a cautionary tale.

Hi Soey,

The following is the medical procedure for Open and Closed LIS:

open technique involves making an incision across the intersphincteric groove, separating the internal sphincter from the anal mucosa by blunt dissection, and dividing the internal sphincter using scissors.

closed techniqueinvolves making a small incision at the intersphincteric groove, inserting a scaple with the blade parallel to the internal sphincter and advancing it along the intersphincteric groove, and then rotating the scalpel towards the internal sphincter and dividing it.
In both techniques the lower one third to one half of the internal sphincter is divided, to lower the resting pressure without destroying the effect of the sphincter. The closed technique results in a smaller wound, but both techniques appear to be similarly effective. Some doctors will close the incision site with stiches and other doctors will leave open the incision site so the sphincter muscle will heal better.

My doctor decided at the time of the operation on witch technique the closed or open LIS. I had the closed LIS with stitches at the incision site. I had banding and LIS at the same time. You can look at my dairy for full details on how it went for me.

Msimon,

I hope you start felling better soon. It does take 6 to 8 weeks for every thing to heal. I wish you the best.

Thanks Fizzman. I really don't know what to think at this point. I have had some relief using nifedipine ointment, which surprises me that I would need it so soon after LIS. Do you know how much of the internal sphincter a 5-6 mm cut would be? I wanted my surgeon to be really conservative so I guess this is what I get. Another surgeon I consulted with wanted to do up to the dentate line, regardless of the fissure length. That scared me.

Sorry I didn't mean to hijack your post Soey

Soey, is botox an option for you?

This is off topic, but I just wanted to clarify:
On my post a few days ago, I certainly didn't mean to imply that one *should* be embarrassed about having AF/LIS - sorry if it came across that way! I just meant that I personally have found it a hard to talk about with friends. It's getting easier but I still can't bring myself to use the word "anal" outside of my immediate family, and my boardie support team of course! (Maybe I'm a little too modest sometimes.) Thank you all for being an outlet for helping me become less afraid to talk about and get help for this!

Good luck, soey & msimon. May we all appreciate excellent health in 2015!

msimon, I had botox and had two nearly painfree months, then it was back to having burning and discomfort. And the botox did kinda upset my hemmie. Thank god it's back to 'normal'(whatever normal is these days).

zippitydoodah, No problem. I'm glad I've never been embarrassed about my asshole haha! I don't tell random strangers, but if someone should ask, I might as well tell the truth. This problem is so common, and yet so few speak about these things out loud..
Thank you, I think I need all the luck I can get now :) Me and everybody else with this problem!

Roidsfizzman, Thank you for giving me much needed information! Don't know what the plan is, but I'm hoping my CRS knows what to do.

Only two weeks left before I'm HOPEFULLY getting LIS. If not.. Guess I just have to get used to THIS being my 'new normal'.

soey wrote:Tucked up because of swelling? That sounds painful. LIS should always be the last option, and in my case it is. I also have IBS, so keeping my stools perfect isnt always easy. I had a good talk with my CRS, and she says the incision site is never inside the anus, so pooping shouldnt be a problem UNLESS You have a active fissure. If my fissure would have been as bad as it was back in february, I would probobly not have been able to deal with the pain from surgery.
I'm From norway btw :)

I just found this thread and it has really confused me. I was told by my CRS that they cut the internal sphincter (which would clearly be inside the anus), and the name of the procedure Lateral "Internal" Sphincterotomy also implies that the cut would be up inside, but you Soey, say that your surgeon says otherwise.

I also see that Zippitydoodah mentioned that my CRS said that he wouldn't address the hemmies at the same time, but I see that yours is bandable. That is clearly a different situation - I had my bandable ones banded a few years ago, and the ones that remain can only be removed by a full hemmorhoidectomy which is something that my CRS wants to avoid at all costs.

Did you have the procedure done today? If so, I'll wish you a really speedy recovery, with as little pain as possible.

msimon wrote:Thanks Fizzman. I really don't know what to think at this point. I have had some relief using nifedipine ointment, which surprises me that I would need it so soon after LIS. Do you know how much of the internal sphincter a 5-6 mm cut would be? I wanted my surgeon to be really conservative so I guess this is what I get. Another surgeon I consulted with wanted to do up to the dentate line, regardless of the fissure length. That scared me.

Sorry I didn't mean to hijack your post Soey

My heart breaks for you, msimon. I hope that things improve for you soon.

I had LIS yesterday, and she cut 1cm off. 5-6mm is in most cases too little according to my CRS. She did not band any hemmies, because I can treat them myself. Just had my first BM, and the pain from the incision site is BAD. However the pain inside my anus is gone.. For now. I truly believe this was the right choice for me.