Okay all, so I had a fissurectomy 3 weeks ago and I do think the fissure pain has gotten less and I really only spasm for a few minutes after a BM where the muscle really clenches tight but man, the sphincter muscle stays SO sore for a large part of the day. Has anyone else experienced pain or extreme soreness in the muscle after fissurectomy? If so, how long until it started to feel less sore. Should note the doc did a little 'manual' stretching of the sphincter muscle. Nothing major and I don't have any incontinence problems. I am happy that some pain is just starting to recede but this muscle thing is really a downer and why for crying out loud do we have to use that muscle for so many things, down the stairs...clench...trip...clench....sneeze...clench....get up from my chair...clench. Talk about insult to injury. I had no idea how much you use that little muscle Thanks all for listening to my rant.

I can't comment on the surgery part but oh yes that muscle, the one we don't even notice until something has gone wrong with it... I sneezed today and tears streamed down my face and I promised myself that I didn't care if it blew my brains out I was not going to sneeze again!
I'm so sorry you're still in this much pain after 3 weeks. I am glad it isn't getting worse and at least there is some mild improvement happening for you though. Hard as it is to do it's so crucial to keep focusing on those little improvements, and rant when you need to rant

So sorry you are in so much pain . I never had "stretch" procedure so I can not be of much help there , just wanted to wish you faster recovery and complete resolution of your problem
Also, I would like to suggest that you do not agree to any more dilation procedures since it is outdated method and almost never used nowadays :roll: . It can do permanent damage ESPECIALLY if they did not asses your anus for natural tears (using sonogram) that can exist in the muscle and especially in women who had children.
Get well soon !!!

I agree if the dilation is uncontrolled and the surgeon just uses his fingers.
But there is a growing body of evidence to suggest that controlled standardized dilatation is just as successful as LIS, has fewer complications since there is no surgical incision, shorter recovery times, and in some studies has lower incontinence rates than LIS, and has the added benefit that it can be safely repeated if needed.
There are several colorectal surgeons in New York offering it, and one we've heard of on this board at the Cleveland Clinic.

jr2 wrote:I agree if the dilation is uncontrolled and the surgeon just uses his fingers.
But there is a growing body of evidence to suggest that controlled standardized dilatation is just as successful as LIS, has fewer complications since there is no surgical incision, shorter recovery times, and in some studies has lower incontinence rates than LIS, and has the added benefit that it can be safely repeated if needed.
There are several colorectal surgeons in New York offering it, and one we've heard of on this board at the Cleveland Clinic.

If there is a scientific paper that talks about that , I would like to read it - could you please add a link for me ???
I read couple of papers that actually suggested the opposite and two of top colorectal surgeons in San Francisco area told me that it was not even taught in medical school any more due to it's "antiquity". May I ask how old is your surgeon ? Or perhaps there is a difference of thought between West and the East Coast , ahahahaaaaa , as with anything else
I personally would NEVER agree to that procedure without detailed assessment of my anus and only if LIS or Botox were not available to me for whatever reason.
Besides, Dilation relaxes anus "temporarily" offering fissure needed relaxed state to heal but once it is back to hyper-tonicity there is a great chance fissure will reoccur. If underlying problem for a patient IS the fact that anus is in constant elevated pressure (as it was in my case) , than only permanent "relaxation" can cure and PREVENT future fissures.
Dilation can cause uneven and uncontrolled breakage of muscle strands and thus cause permanent damage and incontinence. IMO it is very "brutal" method also
BUT, I always say - if it works for somebody - GREAT . I just think that patients should be given detailed explanation and have all pros and cons listed and than let to make an educated decision : ))) and not be pushed to do something just because a doctor is more familiar with that procedure for "whatever reason"

Fissulyna,
I have other research articles bookmarked on my computer that I will dig out for you, but for now, here's a link for two of them
http://www.journal-surgery.net/article/S1743-9191%2809%2900049-1/abstract
http://www.ncbi.nlm.nih.gov/pubmed/15690668
I actually wish I could find a surgeon in my area who did controlled dilation. The surgeons who are performing it nowadays are actually not the older guys (though there are some of those too) who realize that this procedure was done away with when it was known as the Lord's stretch and was done under uncontrolled conditions, but when done in a standardized, controlled way is actually a very viable and effective procedure. The standardized controlled dilatation procedure (not the Lord's stretch) was pioneered by Dr. Norman Sohn in the 90s.
Further, it appears that in parts of Europe standardized dilation is now replacing LIS as the so called gold standard in fissure care because of safety, efficacy and reduced complications.
A member here named WECC has the most dramatic story of healing through dilatation, which is pretty amazing to read and can be found here>.....
http://anal-fissure.org/t4104-my-standardized-anal-dilatation-this-morning
Another member here named BGAN, who is still healing from his standardized dilation is making really great progress in his healing as well.
I also posted a study in the References forum which shows how LIS also only causes a temporary reduction in anal resting pressures, with pressures increasing quite substantially over the course of the first year, so while pressures don't ever return to their normal baseline, they do rise pretty high again, which theoretically may make a person still at risk for fissures in the future. Standardized Controlled Dilation gives us all an option to undergo a procedure that is effective and safe and can be repeated if necessary should fissures recur.

That is than super-great !!!!
The more options one has the BETTER !!!!!!!! We all are comfortable with "this " or "that" for different reasons and even if it is subjective than it still has a FULL merit IMO !!!!
I know that a correct LIS was definitive answer for me and that was the only procedure I would agree to (and particularly one done by a scalpel and not a cauter) . Top surgeons here explaining that "stretch" was "outdated" was something I was soooo glad to hear , ahahahaaaaa ; ))) !!!! All in all - as long as we have ALL options available and everything explained in detail, than and only than we can make final PERSONAL choice with which we feel comfortable trying
Wishing you the best of luck with healing after whatever procedure you choose

Fissulyna,
And that is so key. The thing that is so frustrating to me is I don't have options because where I live the only procedure available is LIS. And given my very complicated health problems and horrific history with surgeries already, I really have a gut feel that LIS is not a good way for me to go. Two doctors i've consulted with who know my history agree with me, but since no one here does dilations, I'm stuck living with multiple deep fissures unless I want to get aggressive about finding a surgeon who will do an LIS on me, even though I would be at higher risk for complications with it, and I'm not sure how wise that is for me to do that. Meanwhile, I'm pretty much in bed every day.
I am so glad to hear your long fissure struggle finally came to an end and that you were able to access care that felt really right for you. It is the best possible outcome!

jr2 wrote:Fissulyna,
And that is so key. The thing that is so frustrating to me is I don't have options because where I live the only procedure available is LIS. And given my very complicated health problems and horrific history with surgeries already, I really have a gut feel that LIS is not a good way for me to go. Two doctors i've consulted with who know my history agree with me, but since no one here does dilations, I'm stuck living with multiple deep fissures unless I want to get aggressive about finding a surgeon who will do an LIS on me, even though I would be at higher risk for complications with it, and I'm not sure how wise that is for me to do that. Meanwhile, I'm pretty much in bed every day.
I am so glad to hear your long fissure struggle finally came to an end and that you were able to access care that felt really right for you. It is the best possible outcome!

I am so sorry to hear about your suffering and I wish I know surgeon in your area that performs "stretch" *sigh. I know of one here in Bay Area if it is of any help. Would you ever consider traveling to have it done ? Oh, I know CA is toooooo faaaaaaaaaar, I was thinking somewhere about hour or so drive from your place ? I had to travel more than an hour to reach CRS of my choice in the Bay Area , but it was sooooo worth it : ))) ! Just a thought
Take care dear Jr2 - you WILL find a surgeon that performs your procedure of choice , just never give up !!!! Did you try "general" surgeons ??? Guy who does dilation in this are is actually "general surgeon" !!!!
Sending you tons of healing vibes and THE BEST possible wishes for forever healing , not only of your fissure but any other health problem you have !!!

Fiissulyna,
I am so grateful for your well wishes. I would love to hear of the surgeon's name you're referring to who performs dilation. The SF Bay area would be a lot closer than NY to me. I'd also be really grateful for the name of the surgeon who performed your second LIS if you would be willing to share that too.