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New with questions

Postby Siphon9r » 24 May 2018, 22:08

I wish I had checked this place out before having surgery as I might have raised some questions. According to my medical history, my CRS performed a "Hemorrhoidectomy, Internal and External, with Fissurectomy". I have since read that the latter is no longer considered standard treatment and wish I had known before hand.

I had the surgery six months ago after a few months where my fissure, which I had bleed off and on for more than a decade, started bleeding badly with every BM and began to hurt more and more. The surgery alleviated the pain and the bleeding was immediately better and stopped within a couple weeks. My also a-hole did look funny, I think what they must mean by a keyhole deformity.

Unfortunately after a month or two I started randomly bleeding again after a BM. This has continued since, sometimes going weeks with no issue. Throughout this time I have been taking Metamucil once a day and pretty much have nothing but loose stools - I am sure a firm one would likely make me bleed. When I do have bleeding there is no pain and I have no idea anything has gone wrong until I see red on the toilet paper.

So, wondering if I should go back to the CRS but am also wondering if I need to look elsewhere since this guy apparently went with the out of favor treatment. Alternatively, I'm not really suffering but I don't want to get back to a bad place again like I was six months ago. Any suggestions?
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Re: New with questions

Postby chachacha » 25 May 2018, 08:21

I would definitely go back to the same CRS and see what he has to say, both about what you're experiencing now, and why he chose the procedure that he did. In many countries (which are you in?), a fissurectomy is still a standard way to treat fissures, so that aspect wouldn't alarm me unduly. Also, if your surgeon is an older man/woman, he or she may have a lot of experience in the field and knows that sometimes one procedure will work better on an individual patient than another. Also, with older surgeons, they will have been trained on the older methods and become very good at them. So, yes, you could look for a new/younger surgeon who performs today's "preferred" procedure, but he or she may not have successfully done 100's or 1000's of them yet, and may still be making the mistakes that lead them to success later on down the road.

If you see your current surgeon again, and don't like his/her answers however, then yes, it certainly wouldn't hurt to get a second opinion.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: New with questions

Postby Siphon9r » 26 May 2018, 13:54

I'm in the United States (TX) and my CRS is probably late 40s early 50s, so not exactly old. I guess I'll make an appointment to see him again. I think he just does older procedures as I was originally going to get a pilonidal cysts removed at the same time as the fissure but ended up opting out after reading about the poor outcomes and complications of the method he was going to use (as opposed to newer methods like cleft lift). Plus the syst hasn't been painful in a year or more so I decided not to invite trouble. Thank you for your response.
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