LIS and Internal Hemorrhoidectomy Together

Having LIS and hemorrhoidectomy on Monday

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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LIS and Internal Hemorrhoidectomy Together

Postby SADuve » 27 May 2020, 10:58

I am scheduled for a Rectal Examination under Anesthesia with internal hemorrhoidectomy on Monday. I also have an anal fissure that the surgeon will be treating also, I assume with LIS, although he will make the determination during the exam. I've read through a lot of posts here and the information has been very helpful. I see posts on LIS and on hemorrhoidectomy, but not at the same time. Has anyone had both procedures done at the same time? I'm extremely nervous and would love to hear from anyone that had both procedures done together.
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Re: LIS and Internal Hemorrhoidectomy Together

Postby patience_and_healing » 27 May 2020, 19:19

Here is a link to one thread that relates to your question: topic13403.html. You may find more such discussions through a forum search. All the best for your surgery. Don't hesitate to ask any questions you have to the doctor, after all they are there to treat us, not lord over us.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
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Re: LIS and Internal Hemorrhoidectomy Together

Postby chachacha » 28 May 2020, 00:49

I had a LIS followed by a hemorrhoidectomy a couple of years later. I read later, that recovery from a hemorrhoidectomy was easier after a LIS, and I believe that is why my own second surgery wasn't as bad as I had expected it to be. Also, mine was a full hemorrhoidectomy, all columns excised, but many surgeons sometimes refer to less extreme procedures as a "hemorrhoidectomy", even if they are not the full shot. All the best on Monday. I hope that your recovery is swift and that you'll return to the forum to share your story.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: LIS and Internal Hemorrhoidectomy Together

Postby SADuve » 28 May 2020, 03:23

Thanks for your reply. I have seen several mention the same thing, that they felt the Hemorrhoidectomy was easier due to the LIS previously. I’m just worried about them being done at the same time, if that will increase the pain during recovery. I will definitely update About my experience.
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Re: LIS and Internal Hemorrhoidectomy Together

Postby chachacha » 28 May 2020, 09:45

I honestly think that it will decrease the pain, because a lot of the pain from a hemorrhoidectomy is caused by sphincter spasms.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: LIS and Internal Hemorrhoidectomy Together

Postby SADuve » 18 Jun 2020, 09:23

UPDATE: I had my surgery on June 1st. Surgeon removed two internal hemorrhoids, both very large and prolapsed. He also performed a fissurectomy hoping to allow the fissure to heal. He uses a drug called Exparel that is supposed to numb the area for up to 96 hours. It seemed to wear off in about 8 hours. The pain has been excruciating. I have had open abdominal hysterectomy and a gastric bypass where they cut my stomach and intestines apart, and the pain of those was nothing compared to this! OxyCodone, HydroCodone, Tramadol all did very little, specially the first week and a half. Surgery was Monday and by Thursday I knew I was constipated. I called the office but never received a call back. On Friday, I finally passed and it felt like my insides ripped apart. Since then BM's were soft but still so painful they sent me into panic attacks. The pain began to lesson around day 11, although BM's still increased it significantly and usually took a couple of hours before it eased off. Each day the pain has lessoned and BM's are uncomfortable but not extremely painful. I saw the surgeon for my two week followup on Tuesday and he said I am right on schedule with healing and pain level. He said he never sees his patients in the first week because they usually don't like him much! LOL He said by week two they tolerate him. Bleeding and drainage stopped around day 5-6 except after BM's.

I also developed a bladder issue that started a few days after the surgery. I am unable to start a urine stream without straining, and even when I do urinate, my bladder does not feel empty. It's like a UTI but no burning or pain. I saw my PCP and he confirmed there was no infection. He and the surgeon both suggest it might just be overactive nerves being irritated by the surgery. My PCP prescribed a medication and advised if no improvement in three weeks to see a Urologist.

So that's my updated experience.
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Re: LIS and Internal Hemorrhoidectomy Together

Postby chachacha » 18 Jun 2020, 18:56

Thank you so much for the update. A full hemorrhoidectomy is one of the most painful procedures to recover from, so I'm glad that you're on the other side now and past the worst of it. I've heard that bladder issues are very common (especially for men - don't know your gender). I hope that your difficulty on that front is resolved soon. Keep up the great work and keep us posted.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: LIS and Internal Hemorrhoidectomy Together

Postby Suffer » 26 Apr 2021, 15:47

I am a women and have significant bladder issues which increase every time I have the re-tearing. Had my fissure for 3 years , 2 Botox one lis no help... have a normal sphincter tone and now referred to urologist for one more time ( normal cystoscopy in 2018, when the fissure an the hell started.
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Re: LIS and Internal Hemorrhoidectomy Together

Postby Suffer » 26 Apr 2021, 15:52

My lis was done dec 2019 and I was suffering for severe bladder, sphincter spasm, urge to urinate etc for 3-4 weeks. Now I re-tear and have all the above symptoms only once a month. Living in a small European country without any good CRS , now looking for a treatment abroad , but continues to suffer due to COVID restrictions and not being able to travel...
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Re: LIS and Internal Hemorrhoidectomy Together

Postby Suffer » 26 Apr 2021, 15:58

My CRS means there is no connection between the bladder symptoms PTI - like and the fissure... but I do believe there is a very strong connection, since I was absolutely healthy before the AF.
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