Hello, I'm looking for some advice. My af hell started in March, to cut a long and painful story short, I healed after 4 weeks doing all the things I found recommended on this site - sitz baths, fibre, rest, stool softener, plus rectogesic and ultraproct etc. I had 5 days pain free after that (it felt like I'd died and gone to heaven, I was so happy).

THEN I had my very first genital and anal herpes outbreak wow.. talk about a spanner in the works. Holy heck. My fissure opened back up, everything turned to crap, a whole new world of pain.

That was 4 weeks ago, and herpes outbreak is cleared up so I'm just trying to heal my fissure again. This time around is less painful, the spasms only last a couple of hours and I'm able to do much more than the first time. I have a colorectal surgeon appointment next week, which I've had booked since my first fissure. I'm wondering whether you think they will consider doing surgery seeing as I healed the first one myself and this one is considerably less painful.. I'm 32 (female) with no children (yet).

Tbh I'm open to having the surgery as I never want this to happen again. I'm a teacher and this whole thing has stuffed up my career for the year, I'm going to be a relief/substitute teacher when I go back as I've lost my position.

What questions should I be asking the surgeon? Any advice? Do you think they'd err on the side of not doing surgery since I've been able to heal previously?

Thanks for any comments.. I'm pretty scared

Hey there, so sorry for the suffering you're going through right now. I have perianal hidradenitis and it's more than enough to just have anal pain to deal with, without adding on one more chronic issue. It's good that the outbreak is clearing up for you. If you want to get the surgery then definitely ask about that. It does have a very high healing rate, but like any surgery it carries risks too. The one that scares most people is the potential for leakage. If you've healed before that's not really a reason not to do the surgery. It means you might be more prone to developing fissures in the future, and surgery could prevent that. Botox is one non-surgical option but it doesn't have a great success rate. Some people prefer it as a first step though.