I am a 45 yr old male with a 20 year history of chronic pelvic floor dysfunction including chronic levator spasm, pudendal neuralgia and dyssynergia. A year ago I successfully applied for disability and since they time, I have been dealing with chronic anal fissures. I had Botox in June of last year and again in January of this year. The Botox does help but I inevitably have a series of difficult bowel movements and I retear. I had one such retear about a week ago and am in excruciating pain. My CRS has told me that she would do LIS if I chose but she has only done a handful of these procedures in the past two or three years because Botox works well for most of her patients. I could push for another round of Botox, I could just take my chances with my CarS doing LIS or I could pay thousands out of pocket to see a CRS in another state who is more experienced with LIS.
I am very worried that my pelvic floor issues will complicate LIS and I’m also worried about my CRS doing LIS given that she’s not very experienced with it. But I don’t want to keep living with this fissure pain and want to do whatever necessary to relieve the pain. Just curious what your thoughts are and what you might do given the above circumstances.