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Fighting a chronic fissure - advancement flap?

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New to the group

Postby butch1000 » 26 Dec 2013, 09:53

Dear all - i had been hunting around for info and was pleased to find this group. So here's my story in brief and maybe someone has some insight as to whether the next step is a wise one.

I've had pretty bad hemorrhoids for about 18 months. These were getting pretty bad with prolapsing and a lot of pain. I reckon the fissure formed around the same time.

The 'roids were treated with banding several times but kept coming back. With my specialist I had discussed various options for treating both the 'roids and the fissure. I started using glyceril trinitrate (bad headaches but bearable).

Though in a lot of pain i still did everything i wanted to, which included a lot of running. Over the last few years running has been a real passion. I have a pretty stressful job with a lot of travel and running was my relaxation and meditation, as well as my way of staying healthy.

The pain was bad though and at times I would be making a work presentation and would need to stop talking to get it under control.

Last May things took a turn for the worse. Whilst out running a had such strong shooting pains i nearly passed out and could barely walk, let alone run. I had to hail a taxi to get home.

In July I had a botox injection as well as higher up banding for the 'roids whilst under anesthetic. I carried on using the glyceril trinitrate. Sadly things did not improve at all. The 'roids were improved but the fissure was just as open and the pain just as intense.

Next step was to trial diltiazem. For an hour or so after application the itching and irritation can be hugely distracting. It did feel that this slowly moves the healing process forward .... but then one heavy BM later and there can be a searing pain and I just know its opened up again. This has happened over and over despite stool softeners and a very healthy diet.

A therapeutic aside:
One thing which i have found useful here is a hand-held bidet unit called 'the palm'. As well as being more gentle and allowing the healing to take hold it is also massively soothing and I can highly recommend one. What turned me on to this was being in a Japanese hotel room with a bidet unit built in to the toilet seat. it was bliss! In fact during the week i stayed there I actually managed to run 3 times.

In September the hemorrhoids were coming back and my doctor and I decided to go for the full Halo treatment to deal with them more completely and at the same time we would trial a second botox injection and also a fissurectomy to try to kick start the haling process. Then carry on with the diltiazem.

Despite a very painful 2 weeks (don't listen to any website or doctor that says back to work in a few days!) rthe halo treatment worked. Sadly less luck in treating the fissure. I think the botox tightened the fissure and things really did start to heal but only to open back up.

In the 3 months since then the fissure feels like it is getting worse not better. The pain is beyond distraction.

My doctor does not feel that I would benefit from a lateral sphincterectomy. It seems my sphincter does not spasm particularly strongly and so does not need to be relaxed, as I know is often the cause of a fissure failing to heal.

My doctor is now suggesting an advancement flap. Has anyone had this particular treatment? I would be interested to know whether it was a: effective and b: what was the recovery process?

There is also another side effect or symptom of the fissure and I would be interested to hear if anyone else has experienced it: when the shooting pains from the fissure are strongesst they seem to be connected to other parts of my body. They will shoot right from the sphincter up to my stomach, shoulder, chin and jaw . Does this sound at all familiar to anyone?
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Re: New to the group

Postby owmybum » 27 Dec 2013, 05:27

Hi, and welcome to the board butch1000,

Sounds like you have been through loads in the last few months!!!

There are a few board members who have had advancement flap surgery.... If you search for suzyljank, she had a double advancement flap last year. She has come out of it amazingly well.
I too may be heading down the road of flap surgery... Im just waiting for a pressure test to be done.


fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Botox June 13
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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