Finally made an appointment with a CRS. I have been dealing with a fissure for 7 months now. I am done. I thought I was going to get in line for an LIS. But the doc said he has pretty much quit doing them and he wants to just cauterize the fissure and let it heal. I go camping several times a year where it can be 10 days between showers, so he recommended taking a tag off just to help keep things clean. He said that would be by far the worst part of the surgery. Anyone had an experience with cauterization alone?
Thanks, this board has been a big help over the past months.

Hi,
Did he say why he doesn't do lis?
I would get a second opinion if possible before getting anything done whether lis, botox, or whatever. It is just sensible to do so and it will make your decision easier.
You might check out these threads;
http://anal-fissure.org/t4277-had-surgery-now-have-a-question
http://anal-fissure.org/t3651-question-about-surgery-and-stiches
http://anal-fissure.org/t3365-fissurectomy-today-wish-me-luck
check for more buy going to 'portal' (next to 'home'), and use the search on the lower left side of the page. Click on 'google' and 'posts' options. then search for cauterize.
It seems like it is a variation on fissurectomy, that heals faster.
I would be interested to hear what works for you.
-Tanya

The surgeon I talked to said he got the same rate of healing and fewer side effects with cauterization alone. It just seems like more people would be getting cauterization alone if that was the case.

Well these things change all the time. Most surgeons don't like to think outside the box. They don't want to lead the way but follow accepted guidelines.
Do you get spasms?
LIS seems to have a higher rate of success for those who get spasms, than it does for those who don't.
Neither CRS I saw thought LIS was even a remote option for me. Not because of any dangers of incontinence, but because they didn't think it would help. I don't get spasms, but for some inexplicable reason I can't seem to fully heal.
I may take the botox option the second guy offered. I would seriously consider cauterization if it had been suggested. I don't know that either guy I saw actually practice that.
There is another forum for fissures on Yahoo that you might check out. You can search their group messages/topics as well. Real nice people!
http://groups.yahoo.com/group/analfissure/
Sure know what you mean by being 'done'. It is grueling and everything else gets shuffled to the side. Hope you find the answer you are looking for!
-Tanya

Thanks Tanya, well I dont really know if I get spasms or not. So maybe that means I dont. I was out duck hunting in the central valley of California last winter. I cleaned a bunch of ducks in a flowing irrigation ditch one night (its more like a creek) and splashed water into my mouth unfortunately. The next day I was sick. Really sick. At the end of that I got a hemorrhoid. Then when that healed I was left with this fissure. And its just never healed. I have done everything I have seen mentioned. But the thing just wont heal. So the cauterization seems interesting.

In all the years and hundreds and hundreds of fissure stories I've heard, I've honestly only ever heard of one person who had a fissure cauterized. For him it was totally successful and he was very satisfied with it. I don't see anything inherently bad about it as a method of fissurectomy. The only problem with it is that if your fissure was caused, and is not healing, because of a hypertonic sphincter with or without spasms, you may get it to heal only to have it recur again. I would probably get a second opinion or even consider having a test called manometry done, which will give you information about the tightness and the functioning of the muscles down there.

I vote 2nd opinion, if possible. That's the one thing I would've done sooner in my case.

Hey there, I'm not to sure about cauterization alone. My fissure was cauterized along with LIS over a year ago and healed beautifully. If I'm remembering correctly Happy Ass another older boardie had his cauterized with LIS too and had good results.
There have been some older post where fissurectomies were performed without LIS and from what I was told- cauterizing serves the same purpose as fissurecomy as far as cleaning up and smoothing the scar tissue of the fissure.... I would definitely get a second opinion though. It just seems to me that if the fissure isn't healing than the muscle is too tight.

So I went for yet another opinion with the family medicine doc who did my vasectomy. He put me on lidocaine and hydrocortisone supositories for two weeks. If that doesnt work he wants to do a fisurectomy in his office and if that doesnt work he want to do LIS at the hospital. He says 60 percent heal on hydrocortisone alone. Of the 40 percent remaining 80% will heal with a fisurectomy and the remaining 8% of the original LIS fixes them up. He is also going to get rid of the tag in his office if it somes to that. So the cost is $100 for the drugs, $1000 for the office and then $20,000 for LIS at a hospital. So with my high deductible health plan, this is the best plan for me.

You need a second opinion of a SURGEON : (((. GPs are notoriously uneducated about this problem : ( and hydrocortisone can actually cause THINNING of mucosa and CAUSE fissures . I am sure some people did heal with small fissure that would heal by ITSELF anyways and thought than that Hydro helped *sigh. BUT, you might try it, if I learned anything with "butts" one NEVER KNOWS what can help LOL. NOW, if I were you, I would not use Hydro for longer than 2 weeks - period !!!! IF you do not heal, than go to CRS who performs ALLL surgical procedures and have impeccable record with LIS !!!!
I visited so many CRSs and I NEVER heard of ONE CRS that does NOT perform a LIS ????????? Did he have bad "record" with it ?????? It is VERY RED flag for me that he is not performing LIS anymore You should not be limited by what particular doctor "offers" but have a choice and do what is the best for YOU !!! He was giving you statistics for ACUTE fissure (fresh one), not a CHRONIC one (like yours that lasts 7 mos !!!!)
Regardless of you feeling or not feeling spasms - they MIGHT BE THERE and by examining your anus manually IF he is a good CRS, he would "feel" if you have some extra tightness there, not to mention that he can measure it with an instrument (by doing manomerty) !!!!!
IF your anus is hipertonic - you NEED to relax it to heal a chronic fissure !!! You can relax it by using special crams (Nitro, etc.), Botox, controlled dilation (which I do not like personally) , or LIS.
Tag removal and fissurectomy will cause MUCH more pain than LIS alone, so if you are going to endure so much suffering and long post-op, than I would make sure in your place you give your anus an actual chance to heal
Wishing you all the best with any procedure you choose to do