My anal fissure Story

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Re: My anal fissure Story

Postby salamon555 » 14 Aug 2015, 21:55

Msimon thx , yes he offered the surgery.He wants to see me in one month to see how I am healing,and then we will discuss my options.We discussed the botox injections.He has done them before and had a 50% success rate.Insurance is hard to say yes to coverage,and right now I have been off of work close to 4 months,so this is an expensive procedure that doesn't have a high percentage of success.By the way, what is the difference between fissurectomy and sphincterotomy ? thx
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Re: My anal fissure Story

Postby msimon » 15 Aug 2015, 02:46

Glad to hear you have options.

A fissurectomy is when they remove some of the scar tissue that builds up around a fissure from repeated healing and tearing. It is thought that this scar issue prevents healing so it is removed, which creates a 'fresh' wound that is easier to heal than a 'chronic' wound.

A sphincterotomy is when a portion of the internal sphincter is cut (usually the bottom 1/4 to 1/3 of it) to relieve the pressure and spam that prevents blood flow to the fissure and allows it to heal. Some Doctor's do both at the same time, depending on how chronic the wound is and how likely they think it is that it will heal. My CRS only did the sphincterotomy as I didn't have much scar tissue.
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: My anal fissure Story

Postby jay1975 » 16 Aug 2015, 10:31

Hey salamon,
You are obviously in a very serious situation and I'm hoping and praying that you can experience some comfort and rest.

My AF is unpleasant, but I'm able to carry on with normal life activities (working, exercise, etc). I do know that there are people on this forum who's life has become a total nightmare, and even with what I've experienced my heart truly goes out to you folks. As bad as the pain is, probably the worst aspect is that it's a very lonely condition. It's not something you can talk to friends or family about. You're pretty much on your own to endure the extreme suffering.
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Re: My anal fissure Story

Postby salamon555 » 17 Aug 2015, 08:04

Jay Thank you my friend and I hope you get back to normal sooner , Msimon , Plz I want to know which the most effective procedure is it Sphin. or Fissu. ? or it is up to the surgeon ?
According to my bad luck and before I make an other bad decision ( like the Colonoscopy) I should carefully chose the appropriate operation for me , so plz any advice will be appreciated .
salamon555
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Re: My anal fissure Story

Postby msimon » 17 Aug 2015, 10:35

Hi Salamon. From what I have read on here, the gold standard surgery for fissures is a sphincterotomy. A fissurectomy can be done at the same time but there have not been many who had just a fissurectomy on here. Of course it is up to the Doctor what they want to do...but nothing can boast a success rate like a LIS (about 98%).
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: My anal fissure Story

Postby salamon555 » 28 Aug 2015, 12:52

Finally I give up for surgery, my surgeon said he is going to do a Sphincterotomy and removing skin tag on Thursday , I m very nervous because he keep talking to me about the possibilities side effect that may happen after the procedure (is that normal??) , hopefully everything goes easy , not surprising right now, since I lost 40 pound .anyway I will update then .Thx
salamon555
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Re: My anal fissure Story

Postby msimon » 29 Aug 2015, 10:52

That's great news that you are scheduled to get the surgery. What kind of side effects is your Doctor mentioning? Is he a CRS? Has he done a lot of sphincterotomies?
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: My anal fissure Story

Postby salamon555 » 29 Aug 2015, 15:13

Sorry I have been posting everywhere , yes my doctor is a CRS and he told me he had done a lot sphincterotomies (he said !) . in his visit I signed some papers and he start talking to me about the incontinent, nerve damage, the fissure may develop a fistula or infection , and because of the general anesthesia I may have a stroke ....
sorry to post this questions here again, my CRS told me that he is going to remove the skin tag ,recently I noticed that I have 3 skin tags, a big one by the fissure and a medium one on 3 o'clock side, then a small tiny skin tag by 12 oclock position . I have been reading that cutting them off is a delaying process of recovery , some cases they came back . then I was thinking that I will ask him to remove the only one by the fissure , in your opinion do you think that a good idea just cutting one ? or let him do what he think need to be done .
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Re: My anal fissure Story

Postby Savaici » 29 Aug 2015, 19:12

As far as I am aware, skin tags appear after surgery in the anal area. I have a few and would not have them removed. Search for sentinel pile or skin tag using the Search which is between the headings of FAQ and Portal above. Search there using the Search by Topic and enter either of the names - sentinel or tag. Then make your decision on that and tell the surgeon of this and in writing. I would not put myself through extra pain unless absolutely essential.

Also, your doctor has to give you all the information on what could (but not would for 98% of the population) happen to cover his back so to speak.
:sunny:
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Re: My anal fissure Story

Postby SakPase » 29 Aug 2015, 19:44

Don't have worries. I posted this in my thread, but I'll post it here, too.

http://www.iscrs.org/data/ISCRS1211/1.pdf

There's a lot of great information on this PPT presentation. Such as:

-Persistent minor fecal incontinence has been reported in 1.2% to 3.5% of patients (seems very low to me...)
-Perianal abscess occurs in about 1% of closed sphincterotomies

-1- LIS is the most efficient surgical method to treat CAF

Don't worry about what could be. My doc has done thousands of surgeries, and he is one cocky son of a gun about it, too.

Every day is better than the last, and I realize this could change and I could have a bad day, nonetheless...don't worry about "what could be..." Get yourself healthy.
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