Hi Ouch,
With LIS there are two cuts a conservative cut the length of the fissure and a more aggressive longer cut to the Dentate line. On the second LIS the cut is typically on the opposite side of the first cut. STOT is correct that you should have a pressure test before doing a second LIS or conformation from a CRS that the S muscle is tight. If I was going to have a second LIS, I would like a CRS with experience to do the second LIS procedure. Doing the fissurectomy is common when doing LIS, but there can be key hole leakage if it is not done correctly. I have had the fissurectomy and I do not have an key hole leakage issues. The value of seeing a CRS for a second opinion is totally understanding your options and risks. If you develop incontinence from the surgery, it is very difficult to correct.
I understand and support you if you make the decision to do the second LIS on Thursday. I wish you the best.

I had my second LIS and fissurectomy this morning. It went well. The dr told me it was a sizable fissure again. My first surgery was in April but I developed another fissure a few months after. So I'm in quite a bit of pain, and an waiting til I can have the next dose of meds. Although I have done this once before, any tips for a good rexovery? When to start taking sitz baths? I am planning to take a stool softener, that will not work like a laxative though right? And should I take fiber or not at this point? I understand that you want it somewhat bulky but too much could be bad. Anyway I'm going to sleep now, hardly slept the night before. Thanks!

Hi Ouch,

It is nice to hear your LIS surgery went well. I would recommend the following: not lifting anything over 15 pounds for two weeks after surgery. Stick to your diet/fiber that makes your stools soft and not too large. Use the stool softener MiraLax as you can take it long term without issue. You can start taking the sitz for up to two weeks as needed, but at some point you will need to discontinue, so the incision site can heal. Drink at least 64 oz of water a day. To clean after a BM dab the area clean do not wipe if you still need additional cleaning use a quick shower or sitz bath. You should expect 6 to 8 weeks for the incision and fissure to heal and 3 to 4 months for the skin to gain back 70% of it strength. If you are using sterile gauze pads to catch the blood, be careful as the cause pads can cause a rash. Follow your doctor instructions.

Thanks for the helpful advice! Is Miralax different from docusate sodium?

They are different, but they function in the same way. Docusate Sodium and MiraLax (Polyenylene Glycol 3350) both help the stool retain water. If you are trying to heal a fissure, I feel that MaraLax is the best product on the market to soften stools. I would recommend that you give MiraLax a try and see if it works for you. Most people on the board with a fissure use MiraLax or the same product under a different brand name in the other countries.

How's it going ouch? I had to have a second lis. 6 months after my first lis I kept having problems so they did botox (my 3rd botox) and after it wore off I ripped again. I had an ultrasound of my rectum done thy showed exactly how much muscle we left to cut- she only nipped it. I'm much looser Andy large fissure hasbt healed yet but the muscle pain from it is so much better. Unfortunatly I got an abscess from it (and possible fistula) so I am taking longer to heal. I wish my crs would have cut more the first time but I understand they want to be conservative. I would say go for it. That said, I have trouble holding some gas now- but I'm also only 2 weeks out. Hope you feel good about what you decide.

I'm ok hopeful, thanks for asking. I'm pretty sore but to be expected. So far no BM, but I have had no trouble with muscle control for gas. Hoping after the weekend I feel even better.