Hello,
I am about to undergo LIS a week from today. My fissure is not that big and I don't have any underlying issues (or so it seems thus far). The location, however, appears to be problematic, as I've had it for a little over a year now, 6 months where it has been severe pain and spasms. It will seem to heal from time to time, but during those times where I am pain-free, I have gone to the CRS and they have still seen the fissure. I usually take enough Miralax and eat enough lettuce to keep myself pain free but every months right after ovulation period, the fissure seems to break open again causing severe pain and spasm (which have been severe and the main source of the pain). I think my fissure is related to my menstrual cycle, as certain times of the month my stool is harder than usual and that causes a retear. I feel that this was initially caused by overseas diet changed induced constipation. I am no longer constipated, but anything slightly harder than the "soft serve" consistency will make a retear and painful spasms. i know I put unnecessary pressure in that area when nervous and I am guessing that my uterus puts pressure on this area during hormonal changes.
Anyways, this fissure has completely ruined the last six months of my life as I was initially abroad but am now at home in agony, waiting to have the surgery. The surgeon is a board-certified CRS but is always warning me about the incontinence risk, which is scary to me as I am only 30 (childless, never pregnant). Is this really a big risk for someone like me? I am pretty healthy, good BMI, work out, eat healthy, had a pre surgery blood test and everything is great.
I don't generally even have stomach aches, so I think the fissure is causing all of my pain and pressure (I also will have tailbone and vaginal pain with retears). Sitting here typing now, I am having the painful spasms but I am very used to it now.
Should I get the surgery with the risk and move on with my life? I have been very aggressive with creams and diet in treating it so far.

Is the risk over-exaggerated? help!

Have you asked the CRS what his personal stats are? I think that success is more related to the surgeon's skill, rather than the patient's health (even though a healthy person may recover faster). My surgeon has never had a single bad result (neither fecal nor gas incontinence) and he has been doing LIS surgery for about 30 years, and doing at least a couple per week. Your surgeon may just be "covering his bases" by warning you about poor outcomes, so you should ask.

chachacha wrote:Have you asked the CRS what his personal stats are? I think that success is more related to the surgeon's skill, rather than the patient's health (even though a healthy person may recover faster). My surgeon has never had a single bad result (neither fecal nor gas incontinence) and he has been doing LIS surgery for about 30 years, and doing at least a couple per week. Your surgeon may just be "covering his bases" by warning you about poor outcomes, so you should ask.

thanks! I think I will call their office and ask tomorrow. He has had 40+ years of experience as a colo-rectal surgeon. He told me about 1% infection rate, 1% anaesthesia problem rate (all the general pre surgery warnings) then get to the "upwards of 10% incontinence rate" which stopped me dead in my tracks...I don't think it is a personal statistic, I think he's just going over the general risk-related things pre-surgery that doctors mention to avoid getting sued...but I'll ask.

I don't think there's any other way to heal this thing and I want to quickly get back to my old life.

He also said recovery was just 1 week... who knows...
would being younger, childfree (I read vaginal childbirth can increase risk of incontinence), and surgery free help my odds? don't really want to live the rest of my life with a fissure or incontinent. If anything, I've always had more issues with constipation and tight sphincter tone.

I was terrified by the stats too, even though my surgeon had a perfect record! I could not live with the pain any longer though and the effect that it was having on my life, so finally decided to "go for it".

I'm sure that you'll hear good news tomorrow from the surgeon's office and then you can make your decision with more information in hand. I had two c-sections, so never gave birth vaginally, so I can't say if that would have any effect.

Going in young and healthy should definitely help on almost all fronts.

Keep us posted!

chachacha wrote:I was terrified by the stats too, even though my surgeon had a perfect record! I could not live with the pain any longer though and the effect that it was having on my life, so finally decided to "go for it".

I'm sure that you'll hear good news tomorrow from the surgeon's office and then you can make your decision with more information in hand. I had two c-sections, so never gave birth vaginally, so I can't say if that would have any effect.

Going in young and healthy should definitely help on almost all fronts.

Keep us posted!

thanks a lot :)

how did your recovery go? I don't mind being in discomfort for a month, as the fissure has been discomforting itself, but i don't know if i can handle more than that emotionally or physically...

If you don't mind TMI, here is my "success story" and a history of what things were like beforehand.

lis-success-for-me-t9369.html

Thanks for the story. Are you able to work out and resume normal activity as least a month post op? I work out and travel a lot for work so I don't know if I can even have the LiS at this point as I can't be bedridden for a month and will have to do a lot of standing jogging and lifting after 3 weeks.

As long as you have an experienced surgeon you have very little to worry about. The LIS procedure is a very minor procedure. I had a Fissurectomy, polyp removal and an Open Lateral Internal Spincterotomy under Local anesthesia. I didn't take any narcotic pain meds after surgery just Tylenol and Advil. My Fissure would have been an ongoing problem without surgery. I'm very thankful I went ahead and did it.

did you have urgency issues after the surgery? Mine did not work for the fissure, which I can accept, but I am now agoraphobic due to these urgency issues. my first BM especially, is big and kind of starts forcing its way out, holding it in is quite painful. I'm scared if I'm in public and can't find a loo in time, i will have an accident. This is, by definition, incontinence, right?