LIS incision site questions

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LIS incision site questions

Postby Worrier12345 » 24 Nov 2014, 11:10

I had LIS two weeks ago and I still have some concerns over my surgery. I can't get to see my surgeon for several weeks so I was hoping that some of you with LIS experience could answer my questions to put my mind at ease, or help me understand what's going on.

I can't really see my incision site, what I can see is a groove/fold/dent on the left side of my anus that was not there before the surgery, so I'm assuming this is my incision site. Worryingly, it looks like my anus doesn't seal shut properly at this part - it's like there is a small gap missing from the anal cushion. There doesn't seem to be any swelling around it like others have mentioned in regards to their incision sites - in fact, the other parts of my anus seem a bit swollen still, but the incision area doesn't.

My concern is that this groove/dent get filled with stool after a BM, it is very difficult to remove. The most disconcerting thing is that once I remove the stool and clean it up, more stool appears and the process goes on for a while.

Did anyone else have this experience?

Will this "groove" fill in as I heal? Or is it here to stay? I haven't seen any blood for a while, and the folds of this new groove just look like normal anal skin - so I can't see that it's going to "heal over".

Since stool is leaking out of this groove after a BM, does this mean that my incision site has formed a "keyhole" or "gutter" deformity?

I'd really like some help on this, since it's been 2 weeks and I'm still experiencing problems with cleaning after a BM, no matter how clean I get, I'll go back and there is more stool in the incision area. Is this normal after LIS? Or am I going to be one of the incontintence statistics?

Thanks in advance for any answers.
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Re: LIS incision site questions

Postby msimon » 24 Nov 2014, 15:50

Hi Worrier. I have been reading on here obsessively about leakage myself as I seep all day and am getting tired of it. Most of the time it is clear/yellow serum (normal) but sometimes it't more mucousy and brown tinted with food bits in it (eeewww, I know) and I am so worried that I don't have a proper seal either. Although I am still really weird looking down there right now with a lot of hard, enlarged tissue on the left (incision) side so I am hoping that will change.

Anyway. I wanted to tell you about a posting I read yesterday (since I have read so many I cannot remember where it was) but this person was talking about having a pocket up by their incision site that would collect BM and release itself at will. Their Doctor found it upon digital exam but it healed itself over in 2 weeks and the leakage stopped. I will see if I can find it...Just wanted to let you know that maybe it's just something temporary like this. I don't know about you but I am expecting things to change quite a bit down there yet...counting on it in fact. I know with hemmie surgery they say that it can take 6 weeks for the 'finished product' so I am trying not to panic.
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Re: LIS incision site questions

Postby msimon » 24 Nov 2014, 16:01

had-lis-10-days-ago-dont-think-it-worked-t5375.html#p77421

Third posting by 'Bumpkin' on the first page.

Not sure if it was infection related or what. Hopefully this doesn't just scare you more...
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Re: LIS incision site questions

Postby Worrier12345 » 24 Nov 2014, 16:17

Hi msimon - as always thanks for replying. Since I've been reading pretty much the whole of the Internet trying to figure this out I've already come across bumpkin's post. At first it gave me some relief but I think that their case was quite different to mine. Mine just looks like this incision site has healed, but it has healed as a deep, wide crease in the side of the anal wall- stool is collecting in it, and once I clean in out, more leaks into it.

I have read what little information there is about "gutter deformity" on the Internet and it seems like this is what has happened. Should this be the case I'm not sure that there is much they can do about it. of all the things I was worried about going wrong before the operation, incontinence barely came into it - as I knew the chances were so low. Now it has happened to me I am utterly crushed. If it were a problem with the sphincter it might have got better since the muscle regains strength, but with a gutter deformity there is no hope of it improving. I can't still can't quite believe this has happened and I'm not sure how to deal with it.

I would really like to hear from others to know there thoughts.

But again, thanks for replying msimon - i hope you're leakage improves soon. It sounds like the kind of leakage that happens when wounds are healing though so try not to worry too much.
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Re: LIS incision site questions

Postby msimon » 24 Nov 2014, 16:38

you are welcome :)

I really hope someone else can be of some help to you. I wonder why that would have happened. I thought gutter deformities were more common with fissurectomies and in the posterior midline...
Dec '13 Fissure from anoscope
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'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: LIS incision site questions

Postby msimon » 24 Nov 2014, 16:52

Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: LIS incision site questions

Postby msimon » 24 Nov 2014, 17:56

You know..I think I might have the same issue as you Worrier. I was poking around back there a bit and around my deformed tissue there seems to be a bit of a hole through which brown mucous comes. What the heck! My Doctor is going to have some questions to answer...
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: LIS incision site questions

Postby Worrier12345 » 25 Nov 2014, 12:31

So I've just come back from the hospital. I made an appointment to talk about my problems with stool leakage since my LIS.

I saw a consultant surgeon - not my surgeon as he wasn't available. The consultant had a look and said the incision had healed up Ok. I told him I was leaking stool most of the day due to what I thought was a gutter deformity. He told me that yes, the gutter deformity is where the muscle was cut. He said the incontinence will probably get better in a few months. I said "so I'm in the 5% that get incontinence then?" he said yes, that's why they don't do many sphincterotomies on the NHS anymore. And left it at that.

I've got a follow up with my surgeon at the beginning of January. Can't say I have much hope in anything any more.

I think I'd rather have bled intermittently from my bum hole for the rest of my life than have shit leak out of me everyday. I feel like I only have myself to blame for pushing for the op.
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Re: LIS incision site questions

Postby Worrier12345 » 25 Nov 2014, 12:59

I'll give it until my follow up in January, if things haven't improved by then I get the dubious honour of being the first person in the history of this board to say: "LIS made me incontinent". I really hope I don't have to make that post.
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Re: LIS incision site questions

Postby owmybum » 25 Nov 2014, 13:12

I'm so sorry to hear this worrier. I really hope as you heal some more things tighten up a bit and the problem resolves itself. Maybe if you are leaking throughout the day you should put a tiny bit of barrier cream on your anus to stop things getting sore.

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