Thanks for the response!
To me, it sounds to me like you have made your decision to go forward with LIS, but are just looking for confirmation that it is the right decision. You and I have been in the exact same position (a fissure AND pelvic floor issues - lucky us, huh?) so I can certainly understand your desire to at least take care of one of the issues. If my CRS had told me that I still had a fissure at my last appointment I would not have hesitated to schedule LIS.
However, how about finding a CRS that can tackle both issues at the same time? My CRS recommended LIS and steroid injections (as opposed to simply lidocaine) directly into the levator ani muscle at the same time. The mixture he uses is Kenalog, Triamcinolone and a long-lasting anesthetic. My CRS said this "cures" levator ani syndrome in about 85% of cases.
I also corresponded with one of the top colorectal surgeons in the country (according to Castle Connolly) and he confirmed to me that he has had success giving patients steroid injections for LAS into the levator ani muscles, as well. He also confirmed that many patients with LAS benefit from physical therapy, as you suggested. Interestingly, he uses a different approach for fissures - he uses controlled anal dilatation instead of LIS. In this way, there is no cutting involved. Here is the link to his website, as well as information on anal dilatation:
http://www.colonandrectalsurgeons.com/AnalFissure.htmlI would also highly, highly, highly recommend you order "UNLEARN YOUR PAIN" from Dr. Schubiner. It only costs about $25 and MAY change your life. It will not help with your fissure pain, of course, but it could help you with the pain associated with your other pelvic floor issues. One great thing about the book is that you can complete the entire program at home in 28 days using his step-by-step process (all you need is some free time and a pen or a pencil). Note: I have absolutely no association at all with Dr. Schubiner (other than ordering his book and corresponding with him via email).
Good luck!