One year post-op. Where to from here?

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One year post-op. Where to from here?

Postby TexasTom » 15 Sep 2014, 22:36

Hi, my name is Tom and I am new to this site. I am a 33 year-old male. I have suffered from anal fissures for the past 8 years, with increasing frequency and severity during that time. Most recently, I was under treatment for a very painful and persistent fissure for about two years. Ultimately, the fissure would not permanently heal with ointments (nitroglycerin, proctozone) and I decided to have surgery (fissurotomy/sphincterectomy). I was terrified of the surgery but motivated by the dream of being "normal" again, so I went for it. My surgery was almost exactly one year ago. The procedure has not had the outcome that I had hoped and I feel, frankly, broken-hearted.

There has certainly been improvement. Pre-surgery, 90% of my bowel movements were excruciating and bloody, and triggered pain that would last throughout the day and into the evening. Things are much better now: pain and blood are rarer, less intense, and pass more quickly. In fact, over the past year, I have had stretches of 1-2 weeks at a time where I would even say that I even felt "normal". That is, I wasn't evening thinking about my butt (imagine!). But those good stretches have been frustratingly fleeting. I just cannot hang on to that normal feeling, and it drives me mad! More often, my condition ranges from mild to moderate achiness - with the pain sensation very much centered on my surgical scar, and typically triggered by bowel movements - to new tears and bleeding...essentially new fissures, though I am not sure if there is a technical distinction between a fissure and a re-opening of the surgical wound (which is what I think is happening). Some days I feel like I simply traded a fissure for a surgical scar, which can feel all too similar. I have been back to my CRS and he points out, rather cheerfully, that whatever new tears I experience seem to heal on their own, suggesting that the procedure was successful. (I guess he has a point...?) And in case you are wondering about diet, I am absolutely fanatical about water and fiber. As far as I understand, I am doing everything I can to promote my anal health. And yet, my butt still hurts.

My CRS, true to form, is a poor communicator (though I am confident in his skills). I don't have a good sense from him what I should expect at this point. Should I be completely back to normal by now, or are the sorts of setbacks I describe more the norm? Does my experience sound familiar to anyone else out there? I'm beginning to get resigned to the fact that I will deal with this for the rest of my life. Is that too fatalistic? Is there hope of a true, complete recovery?

Two other things about me that I think are relevant:
1. I'm an athlete (distance running, cycling, yoga, team sports, weight training). My CRS says there is nothing wrong with athletic activities as long as I am not straining too hard. I have not noticed any obvious associations between exercise and my anal problems (though I have to stop cycling when things flare up). I do wonder about this, though. Does anyone know if there are general trends regarding positive or negative effects of exercise on the occurrence of or recovery from fissures?

2. As a gay man, this issue intersects with my sex life. We probably all feel a certain loneliness about our conditions because they are difficult to talk about except with the closest of friends and family. This site is a blessing in that regard. I feel especially lonely because I want to talk to someone about sex and I feel like I have nowhere to turn. My doctors are not helpful. They are either sympathetic but uninformed, or completely uncomfortable with the topic. I have not had anal sex (as a bottom) in many years (I've been abstinent in that way since this problem started...a long time ago!). Is it possible to resume a healthy sex life post-surgery? My first priority is my health, but I also like to imagine a day when I will return to the (healthy, unremarkable) sex life I once had, though the thought terrifies me.

Thank you for reading my story. I would be delighted to hear yours.

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Re: One year post-op. Where to from here?

Postby owmybum » 16 Sep 2014, 06:36

Hi Tom.... And welcome to the forum!!

I'm sorry to hear you are having so many problems after your surgery. It does sound to me like you are still too tight down there if you are still fissuring regularly.
Do you think you might go for a second opinion with a different CRS? Just to get a fresh pair of eyes on things?
It sounds like you are doing everything you can help yourself heal, so maybe the cut was too conservative?

It must be so hard to be a gay male with this chronic problem. I can imagine this must make you feel very isolated and unfulfilled.just that alone can have massive effects on your mental health and well being.

As for exercise..... I'm not sure if weight training is the best thing to be doing... Rectal prolapse springs to mind with all that pressure!!!

This is a great forum, where we can all talk freely, so I hope you get alot out of it in the future.

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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Re: One year post-op. Where to from here?

Postby mmklinemm » 19 Sep 2014, 21:49

Hey Tom! I've not had surgery, so I can't speak from experience. From what I've read here, it seems like 2 years is the average time for complete healing. It's sad to say, but you may need to back off your athletic activities to break your cycle. I was an avid runner before all of this. I've had to drop back to only walking, and when I push too fast or far I end up bleeding.

This can be such a lonely condition. I'm sure, at some point, you'll be able to return to a healthy sex life. There are a number of gay men on here. Hopefully someone will see your post and chime in. I'm sure they can relate and help more than the two of us chicks. :D
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