Next Tuesday. I replied to one of your other posts too. I'd say try the fissurectomy and Botox and then go for LIS if the fissurectomy and Botox don't work. My CRS has a 90% success rate healing fissures with Botox and fissurectomy.

Thanks few more questions
Are you going private?
Is your fissure at the front or the back?
And over the 10 years has it been the same fissure that keeps coming back and how often? Mine is monthly.

I have Bupa private insurance and am going private. I prefer that as you can pick the CRS you prefer etc.
My fissure is at the back. I first got a fissure in spring 2007 and it took a good three to four months for me to figure out a diet and stool softener that worked as I didn't see a GP. I had re-occurrences two or three times a year (a bit of bleeding and pain during BMs, nothing major) until November 2010 when the fissure came back with a vengeance. I went to the GP and got some cream and Movicol. I had maybe one recurrence a year until March 2014. I went back to the GP and got more cream and a prescription for Laxido (same active ingredient as Movicol but it seems to work better for me than Movicol). I healed within a month. Or at least no pain after a month. I don't know it it was fully healed or not as I currently have a fissure but no pain. I saw the CRS a week and a half ago and he saw a fissure although I had no pain then either. I was fine using Laxido from March 2014 until late March this year. I'm very annoyed as it's 100% my fault that the fissure recurred this year. I decided to swap Laxido for lactulose and it took less then a week for my stool to get hard and sticky and requiring a lot of effort to evacuate. This fissure is by far the worst as I had spasms for six to eight hours after BMs the first five weeks. I used diltiazem and it seemed to work. I have been pain free since I stopped putting what two different GPs said was an internal hemorrhoid back inside. It's a sentinel pile and should be left alone.
I don't know if it's the same fissure or different fissures. They've all been in the same location.

I hope the Botox, fissurectomy and sentinel pile removal will allow me to get off stool softener in the longer term. My CRS said I can't ever get constipated again as I'll get a fissure again then.

Am I correct in assuming your fissure seems to heal and then recurs again monthly (is it related to your menstrual cycle)?

Wow that's such a long time an I can't believe the doctors told to push your skin tag back in ouch when my fissure is really playing up the skin tag is big red an angry an creates most the pain during that time I can't even touch it. I've always thought my monthly cycle had something to do with it an breast feeding because during a monthly cycle an breast feeding you estrogen is super low which creates dry weak skin that doesn't heal well even my midwife said that's what she thinks is causing it my fissure started while breast feeding my first son 3.5 years ago then it came an went every month then this time while pregnant the last 5 months while eastroge an blood flow are super high I didn't have the fissure at all but once my bsby was born an a few weeks into breast feeding boom it was back an its been hasn't gone away since I can't get it to heal just trying to count down the days till my appointment and when I give up breast feeding at 6months.

It seems like there's a good chance that your fissure will heal once you stop breast feeding. Botox and fissurectomy should help you heal quicker than without any intervention.

It was extremely painful for hours after I'd pushed the sentinel pile back in. I'm guessing that's because it pulled on the fissure when it was inside rather than peeking outside. It proves that GPs aren't that good at diagnosing bum issues...

Tell me about it I've had 2 or 3 doctors tell me there's no such thing as lis if someone cut the muscle back there you would poo yourself an I told me that to fix a fissure they just get their fingers an stretch it causes more fissures which I know is the lords operation but how out dated are these doctors don't the have to do refresher classes or something there no good to me in this small town where I live they are a waste of time they gave me rectogisic because they have never heard of the other two but rectogisic give a daily head ache.

Kv12 how are you going?

I'm doing well thank you Missy. Drove for the first time today and was good to get out of these four walls. I can't do too much as I appear to be healing well and I'm not going to have a setback!

Pain is about a 3 after bm but a useful hand shower eases the pain and after 3-4hours I have no pain at all. I don't bother with sitz baths anymore the shower is much better for me.