Thank you, Dawn! I appreciate the info.
Honestly, I just want this to all be over. I just want to feel better and live my life - just like everyone else here.
Right now, I'm hoping this darned thing will heal, or is healing. That said, I'm open to whatever it will take to get me there.

Dawn, btw, I'm printing some of this and taking it to my crs, to talk it over with him. So, thanks, again!

Posting what I gleaned, as adding to this posting by wecc seems to be the best place.
I can understand that LIS is the surgery of choice, but for others (like me - older and with a lot of scar tissue in the region), other less 'radical' options do appeal.
1. and 2. are randomized Trials for Controlled Anal Dilation dated 2009 and 2010.
Also here is a link to 'Operative procedures for fissure in ano.' Note the final comment in the MAIN RESULT of this study to be found at:
http://www.ncbi.nlm.nih.gov/pubmed/22071803
Randomized Trials for Controlled Anal Dilation:
1. Yucel T, Gonullu D, Oncu M, Koksoy FN, Ozkan SG, Aycan O:
Comparison of controlled-intermittent anal dilatation and lateral internal sphincterotomy in the treatment of chronic anal fissures: a prospective, randomized study. Int J Surg; 2009 Jun
* [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
* [Title] Comparison of controlled-intermittent anal dilatation and lateral internal sphincterotomy in the treatment of chronic anal fissures: a prospective, randomized study.
* AIM: The results of controlled-intermittent anal dilatation (CIAD) or lateral internal sphincterotomy (LIS) in the treatment of chronic anal fissures are presented.
* The pre- and post-operative mean anal canal resting pressures (MACRPs) and symptoms were recorded and the results were compared.
* RESULTS: Two months post-operatively, 18 patients in the CIAD group and 17 patients in the LIS group had healed completely, and had no anal incontinence or other complications.
* No statistical difference existed in the pre- or post-treatment MACRPs between the groups.
* CONCLUSION: CIAD applied with a standardized technique reduced anal canal resting pressure and provided symptomatic healing that was equivalent to a LIS.
* Since there were no findings of incontinence, or situations which resulted in sphincter damage, we conclude that CIAD is suitable for patients with chronic anal fissures because it is less invasive than LIS, with equivalent efficacy and safety.
* In addition, the CIAD method may be an alternative procedure in older and multiparous women who has a higher risk of incontinence.

* MedlinePlus Health Information. consumer health - Anal Disorders.
* [Affiliation] Sakarya University, Sakarya Medical School, Department of Surgery, Sakarya, Turkey.
* [Journal-full-title] International journal of surgery (London, England)
* [Publication-type] Comparative Study; Journal Article; Randomized Controlled Trial
* [Publication-country] England
1. Santander C, Gisbert JP, Moreno-Otero R, McNicholl AG, Matй J: Usefulness of manometry to select patients with anal fissure for controlled anal dilatation. Rev Esp Enferm Dig; 2010 Dec;102(12):691-7
* [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
* [Title] Usefulness of manometry to select patients with anal fissure for controlled anal dilatation.
* AIM: To evaluate the use of anorectal manometry to select patients for controlled anal dilatation.
* METHODOLOGY: A prospective study was performed using anorectal manometry on all patients with chronic anal fissure who did not have a good response to conservative treatment.
* Those with increased anal resting pressure were treated with controlled anal dilatation using a two valved anuscope.
* A second anorectal manometry was indicated after controlled anal dilatation.
* RESULTS: 19 patients without anorectal pathology (Healthy Control Group) and 57 patients with chronic anal fissure were included in this study.
* Controlled anal dilatation was performed on 27 patients, maximum resting pressure 122 ± 19 mmHg.
* In the controlled anal dilatation group the healing rate was 92.5%, mean maximum resting pressure post-controlled anal dilatation was 91 ± 30 mmHg.
* We found one case of transitory anal incontinence (3.7%).
* None of the patients had anal incontinence at 18 months of the follow-up.
* In the remaining 30 patients non selected for controlled anal dilatation (chronic anal fissure control group), a proportion of 53.3% recurrences were registered after conservative treatment.
* CONCLUSIONS: Anal healing of chronic anal fissure and a significant decrease in maximum resting pressure recorded by manometry confirms the success of this procedure.
* The manometric evaluation of the maximum resting pressure is useful in the selection of chronic anal fissure patients for controlled anal dilatation.
* The efficacy of dilatation to treat chronic anal fissure in patients with raised anal sphincter pressure was high and complications were rare.

* MedlinePlus Health Information. consumer health - Anal Disorders.
* [Affiliation] Department of Gastroenterology and Coloproctology Unit. La Princesa University Hospital. Universidad Autуnoma de Madrid, C/Diego de Leуn 62, Madrid, Spain.
* [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
* [Publication-country] Spain

Hello from Hong Kong All. 18 hour flight here…no pain whatsoever. Last time I was in Hong Kong I had a re-tear 2 hours before my flight home and I wanted to jump off the plane. This time I read a great book and slept.
Yes indeed Dawn, while it’s not a secret in other parts of the world, for some reason that I will let each of you draw your own conclusion, it is here. The underlining word is “standardized” AD….Research or not, I can tell all of you, this has truly been a god send for me and my family. Fact is, I know the success I have had with this. I have not taken this for granted and changed my lifestyle. Besides all the other changes, I am taking fiber pills. The reason I bring this up is I have had some very large BM’s and I have not have any pain whatsoever during and no spasms after. I see my CRS for my follow up and will let all you know what he says. The reason I am still posting is I want other to know that there is another option besides a LIS with much less side effects. If you have read all my posts, you can see what I mean.
For all of you who reed my past posts after my AD and think it sounds too good to be true, most times it is, this is one of those times. I just all of you could have seen me before this and the pain I was in and see me now. Heck I wish you could have seen me 2 days post AD. I am having a hard time believing this myself and still waiting for the other shoe to drop….this is way tooooo easy…especially after reading so many posts from others after an LIS… I hope that one day this becomes the gold standard here.

Great hearing how good it is going for you wecc! Wow! A flight to Hong Kong. I can't even make an appointment to see my GP in the mornings, as am in such pain with spasms.
Really getting all my information together, though it will take me a few months to go forth. Winter is severe here, and don't much fancy flying in minus 25c weather and snow.
Please keep up your reports!!! Thank you. And congratulations too...

Hi wecc....you see...what I said...it will work for you ! Great that you having back your life again !!! I am very happy that I did this AD also and I hope I will get rid of the pelvic disorder and the pelvic pain syndrom as well soon and that the AF`s will never return !!!

Hi Everyone….back from Hong Kong. About 18 hours each way…no pain whatsoever! Just about a month ago I could never, ever think about making a trip like this, let along a 1 hour flight. I have my AD follow up with my CRS this Monday. When I talk about how an AD’s is the standard in Germany and Japan…as you can see Val is from Germany and had an AD using a balloon…
Again for some maybe an LIS is the way to go…however with that said, I hope for all of you who are in pain and do not for whatever reason want to get cut, truly reduce your healing time and chance of complications…. look into this...there truly is another way to go when you get to that point....perhaps if more people just kept telling their CRS about this…just maybe it will be more common here in the U.S
I will let everyone know about my follow up visit and what this CRS say about the fissure. For all of you that continue to PM me, I will not be visiting this site as much going forward. I have posted much info on this site about this form of an AD. Again, I have reed about the successes that many have had with an LIS and I have read the many that have had complications. And while I understand that for many an AD might not be available because of where they live. My only comment is just do not leave any rock unturned. I called up 20 plus CRS’s till I found what I was looking for and given my success from day one and everyone I have met in my CRS’s office who have had the same level of success….I for one would never have an LIS if I could find this..... but that is just my option......

wecc - I don't mean to presume - but in the course of your visit with your crs, could you please ask him if he knows of anyone else in the U.S. who does the AD?
I asked my crs about it yesterday, and he waved his hand and said, "No one here does this," and he seemed completely unfamiliar with standardized AD.
Again, I do not mean to presume - and if you don't feel it's appropriate to ask your crs, or you don't feel comfortable about it, that's okay. I've called that office, and I've yet to hear back from them.

100% I will indeed ask him. Your CRS was just like my first. From my point...i do not care what others might say, I know the success that I and others have had with this.

I am from the same general area as Sweet Bugaboo and would also be interested to see if there is a doctor in the California area. Thanks for all of your great info.