Considering LIS -incontinence rate??

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Considering LIS -incontinence rate??

Postby smiles » 11 Aug 2013, 12:08

Hey guys,
I am *thinking* about LIS.. I have had my fissure for about 6 months now, but I am going to wait another few months before I start planning surgery.. in the mean time, I'd like to start getting some facts about LIS..
What are the chances of developing incontinence? I'm picturing the worst case scenario.. I'll get the surgery, and will have to wear diapers for the rest of my life -_- I'm only 22 years old.. so I can't imagine spending the next 60-70 years having to wear diapers?? hahaha.. is the incontinence rate permanent? What are your experiences??
Also, does anyone have any good recommendations for someone to perform this surgery in Ontario, Canada?
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Re: Considering LIS -incontinence rate??

Postby smiles » 11 Aug 2013, 12:12

Oh and also.. is it possible to have the skin tag removed during surgery? Might as well kill two birds with one stone Image
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Re: Considering LIS -incontinence rate??

Postby jr2 » 11 Aug 2013, 12:25

Hi smiles
Can't help you with a surgeon, but as far as incontinence goes, there are a lot of things to consider.
First off, it's important to understand what is meant by incontinence. With an experienced and qualified colorectal surgeon, and assuming you have no bowel troubles like IBS or inflammatory bowel disease, full incontinence to stool is very rare with LIS. Incontinence, when it does occur, usually means having trouble controlling gas, varying degrees of leakage of stool, and a decreased capacity to tell the difference between stool and gas in the anal canal.
Second, the sphincter muscle is at its weakest just after the surgery and for the first year or two. After about a year or two the muscle strength builds back up to about 80% of what it was previously.
Third, incontinence rates for LIS in the medical literature range anywhere from a low single digit percentage risk up to 30%, so there is quite a lot of variation in studies.
Fourth, as a young woman who might be planning on having pregnancies in the future you also need to consider that obstetrical trauma with labor and delivery can further impact the functioning of the sphincter and add to the potential for problems with incontinence. If you are planning on LIS and you are hoping for pregnancies it would be a good idea to consult both with the colorectal surgeon and your OB/GYN first to discuss these risks and the different options.
Fifth, there is also a chance that as you age you may have an increased risk of trouble with sphincter control as you add the natural weakening of the sphincter that will take place with the aging process.
And yes, the skin tag can be removed at the same time, though keep in mind that will also increase the recovery time, pain, risk of infection, etc.
Hope that helps!
Wishing you all the best with your healing!
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Re: Considering LIS -incontinence rate??

Postby Bambi » 11 Aug 2013, 17:34

Hi Smiles,
    I am in Colorado so I can't help with a surgeon either. But I wanted to chime in about LIS. I had LIS and skin tag removal in Feb of 2011. Of course, everyone is different but I would strongly encourage to do the surgery sooner than later. You may as well get it over with and then truly begin to heal and regain normalcy (yes that is possible!) from what I've read, the incontinence rates are somewhat inflated because of the older age of some of the study. I am 59 and I had slight leaking (irritating but only a tiny bit) that gradually over the first few months declined significantly. At this point, I don't have even that anymore. And assuming you have typically good muscle tone at 22, you might have that for a shorter while. I had 2 rounds of Botox and waited too because of fear. After a year, I had the LIS and it wasn't easy,but the recovery was a steady slow ride up to healing instead of the roller coaster I was on before...good luck!
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Re: Considering LIS -incontinence rate??

Postby smiles » 11 Aug 2013, 17:50

Wow.. thanks to both of you for your responses!! :) I really appreciate it.. Bambi, how long did it take you to heal? And how long would you say you were "out of service" aka having to lie in bed, not work etc..
Also, how long did you wait until you went for surgery? Did you try all the conservative methods beforehand?
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Re: Considering LIS -incontinence rate??

Postby Bambi » 11 Aug 2013, 18:59

I'll try to remember-I almost need to go back and read my own posts from back then. I am a retired teacher, so I was lucky to not have to push myself back to work. And on The advice of all the wonderful folks on this site, I was unusually good to myself. So I definitely spent most of the first week really taking it easy and mainly lying on my side on the couch. I gradually increased my activity level and tried not to sit much until week 2. If I had still been working, I probably would have pushed myself more and maybe have gone back to work week 2. It wouldn't have been ideal, but I probably would have been ok. I think if you have a situation where you have an understanding supervisor you could explain things to at work, that would make it easier to then do half days week 2. I know I was very lucky to be able to take it that slowly. It seems like many Drs will make it sound like you should be right back to normal in a day or so. That is really a disservice to people.
It really was a gradual return to normal-not as fast as I wanted but looking back, my fear that things would never be better was only making me miserable and really wasn't true. Hindsight helps! My surgery was in the middle of February and by June I remember posting that I was a lot better. The skin tag site took longer to heal and that seems to be the case for many of us. But I would definitely still have it removed. It was a pain all on it's own and who needs that thing always getting irritated?! Feel free to ask memory and I'll do my best to answer.
Oh-I went 11 months and tried all the things to try. The prescribed creams, etc... I first got the fissure in March of 2010 and it briefly got quite a bit better in September only to return the day of a vacation to the beach with my sister. She convinced me to seek it a surgeon when I returned home and so I did in October. In November I had the first round of Botox. Things were a little better. Round 2 of Botox in January 2011 . Once again, better but not really. Just enough to confuse me and make me wait to call the Dr back. He finally called me on a Sunday afternoon (a shock!) and said he was checking up with me. He said it was time to schedule LIS so we did. I am so glad he called because I was very confused since things were not as bad, but just bad enough to make me generally miserable and anxious all the time...
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