Hi All,
My journey has been a longer one, although not as long as some people on this forum.
It started about a year ago when i developed a perianal abscess, and had to go to the emergency room to get it lanced and drained. A few weeks went by and it healed up, but there was a hole above my anus. It turns out the abscess had created a fistula. So I ended up having a fistulotomy by a general surgeon. It was a simple case, no seton required. Over the course of a couple months it healed to 90% then stopped. Another 4 months went by and no healing progress was made. Finally the surgeon referred me to a CRS, who said that it was likely a fissure all along that eventually became infected and abscessed, thereby creating a fistula (and that these may not always heal on their own). This made sense to some degree because i did remember having some pain/blood during bowel movements weeks/months before the ER, but always thought it was hemorrhoids. So the CRS prescribed me ditiazem cream, which i have used for about six weeks. It managed to heal the fissure about 50%, but will heal no further. The CRS said that i can either continue the cream, leave it be, or get surgery (in this case either botox or LIS).
Currently i don't have a whole lot of pain and the fissure is smaller, maybe half a centimeter. Cleaning the area so that it does not become agitated is a real pain and i am getting tired of it. It us unlikely the cream would yield any further results, and i don't think i am fond of leaving it be due to the fact that it can become worse over time (or create another fistula even) and i will likely end up on the operating table eventually. Botox from what i have been explained and what I have been reading is a coin toss. So I am considering LIS surgery. I understand there are some risks with the surgery and while my current symptoms aren't terrible, i really would like to nip this in the bud and get it healed as well as reduce the chance of reoccurence in the future (this is the most major benefit as i see it).
Does this decision to proceed with LIS sound unreasonable given the risks? Are there any other options that should be considered?
Thanks.