I have had an anal fissure for over two years. Have posted on here before, but I've had two LIS and fissurectomy surgeries. The first was April 2014 and I was healed but the fissure returned 4 wks post op. Tried Diltiazem again but didn't heal. Second surgery was the end of October 2014. Healed and had return of fissure at 5 weeks post op. The dr who did my surgeries is a general surgeon, he admitted he was conservative the first time. He sent me to a rectal specialist, and I was seen by the specialist yesterday. He was able to see the fissures I have and the scar tissue from surgery. He says that he believes that the second surgery should have been done on the opposite side, since the cut was made in the same spot both times. Anyone heard this? I do trust him and he does many of these. He also said that he believes the fissurectomy does more damage than good and prefers to only do LIS. So he offered either some botox injections, or trying for a third LIS, done the opposite of where it was done. Has anyone had luck with botox? Did it hurt much after? I honestly can't agree to go ahead with botox because if it doesn't work then I would be going back for the LIS. It makes more sense to me to go straight to the LIS. I have young kids and it's very hard to coordinate their care as well as someone to take me to the hospital and drive. I don't want to risk the botox failing, although I know LIS can fail too as that's happened to me. I'm optimistic that it works this time since he specifically deals with rectal surgery and is known to be very good at this. What is your input? Oh and so far I have no incontinence. I just have horrible pain and I bleed with each BM. It's hard to deal with this and be a mom.

ouch4466, sorry to hear you are struggling at the moment. I had botox several months ago and it did work. It made a difference, but only for two months then I was back to painful BM's and pain during the day aswell. I had LIS 3 days ago and I wish I would have done it sooner. botox is only temporary, LIS will -in most cases- cure the pain forever.
All i can tell you is to find a surgeon that has a high success rate. This was my first LIS and my surgeon cut 1cm off. I'm not even close to being incontinent(yet anyway) and this is 3 days after surgery!
Only you can decide at the end, and i hope you and your CRS make a good decision together.
I cant even imagine having kids and dealing with this pain at the same time.

Best of luck <3

Oh i forgot, botox tend to upset hemmies if you have any. Mine got extremly painful a month after the botox injections. So even if the fissurepain was gone - the hemmie gave me a new hellish pain.. But this is ME, and we all react differently to botox(and everything else).

Thank you for your input. I'm glad to hear that you're happy with your LIS so far and hope you recover quickly. I am going to go with my gut feeling and trust the crs to do my LIS. I just don't think botox is going to work since everything else seems to fail for me and I have such a tight spastic sphincter. Never thought I would say that in a message board lol I also do hav hemmies and really don't want to aggravate them more as one is already big. For now the crs wants to leave those alone as they aren't painful at the moment and are just slightly annoying. I trust him because he knows his stuff as far as I can tell and the previous surgeon didn't ever give me much info on anything. He was so rushed and never really explained things well. And also took an hour to hour and a half after my appt time to see me. He also told me I don't have hemmies, and I have been told by my new crs and another dr that I do. :) Agan thanks for your reply