3 months post lis and fissurectomy

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Re: 3 months post lis and fissurectomy

Postby Jsingh » 14 Jan 2014, 12:46

Skumar and hatetopoop...I think it is too early in the game to start thinking about a second lis although I can very well understand your anxiety...the most important thing early on is lack of pain during a bowel movement..once that is happening it generally means an adequate cut...
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Re: 3 months post lis and fissurectomy

Postby suzyljank » 14 Jan 2014, 13:23

Hi, feeling a little tight after LIS could be from swelling especially if you are only a few days out from surgery. If you're still feeling tight a few months out you're cut may have been too conservative or you may have too much scarring (stenosis). I had stenosis. After my LIS I felt just a little relief but in just a few months I was back to square one. I went back to the CRS and he confirmed stenosis but I was so afraid of further surgery I waited 5 years before I finally did anything about it. That was last April. I just this weekend got up the courage to look at photos from my surgery. I'm really glad I didn't look sooner but after seeing how it first looked and how it has healed I'm amazed. If I had to do it all over again I wouldn't have waited so long. Go back to your CRS, they can tell by a digital exam ( I know ouch) whether you have further narrowing there. If you catch it while it's mild it can be treated by dilation and stool softeners, if you wait to long like I did, surgery was my only and last option. Good luck Suzy
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Re: 3 months post lis and fissurectomy

Postby Hatetopoop » 14 Jan 2014, 13:29

Thanks Jsingh and susyljank for your quick replies. I just don't want to retear again. I have little to no pain pooping; I just have a hard time doing it. I have the pain afterwards but it's not a fissure pain; it's a soreness and sometimes spasms. Sometimes now I get a shooting pain here and there that stops me in my tracks. Suzy, what type of surgery did you finally have to correct your problem?

You know what, I am no longer scared of surgery. I was TERRIFIED before my first one. Whatever it takes, even if God forbid I have to do this again, I will never wait this long and suffer the pain of a fissure. Agreed!!! It would just be a terrible bummer but I'm praying and hoping it's just too soon to tell. Seeing the dr on Monday....
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Re: 3 months post lis and fissurectomy

Postby suzyljank » 14 Jan 2014, 14:07

Hi, my surgery was called bilateral sliding flap anoplasty. It was a double advancement flap with the donor sites left open to heal. My doctor did that so there would be not tension around the flap site when it healed. Like I said above I just saw the photos of it and I'm glad I didn't look right after the surgery. It actually looked worse than it hurt and it would have scared the heck out of me. Suzy
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Re: 3 months post lis and fissurectomy

Postby Hatetopoop » 14 Jan 2014, 16:55

Owuch!
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Re: 3 months post lis and fissurectomy

Postby asdf123456 » 14 Jan 2014, 18:49

Hi Suzy, I read your story a while back, and if memory serves, it sounds pretty similar to mine. I also had a botched Hemmy surgery that caused a stricture and stenosis and two unhealed wounds, anterior and posterior. Exactly one year later I had LIS and a stricturotomy. My BMs are much better, and the anterior fissure totally healed. The posterior fissure is still there however, at least partially. My doc gave me botox again (that's the 3rd time now), and has been cauterizing the wound in the office every few weeks. The dam thing won't go away. He recently mentioned that I could try v-y advancement flap surgery, but this would be more of a recovery. I am fine with that, but I was wondering, does this cause permanent disfigurement to the butt-check area? I am 25 M, and I don't anticipate mooning anyone in the future, but in case I am ever going to be skinny dipping or streaking, I would like to know if they are going to take a piece of my butt cheek and shove it up my ass. I know that sounds weird.
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Re: 3 months post lis and fissurectomy

Postby asdf123456 » 14 Jan 2014, 18:52

Additionally, what shape flap did you have? and did you have manometry done? My doctor also suggested that we could try LIS again, but I am not convinced that my wound is spasm related at this point…after 3 botoxs, creams and even LIS...
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Re: 3 months post lis and fissurectomy

Postby suzyljank » 14 Jan 2014, 19:22

Hi asdf123456, they did take skin grafts from my butt cheeks and suture them around the opening and inside. They left the graft site open to heal so it's also new skin and less likely to pull at the opening once it healed. I do have some scars. The grafts were taken very close to the anus so unless you're mooning you'd never see them. My recovery time is 2 years and my CRS said the skin will eventually fade to flesh tone again. Periodically my hubby checks for me to make sure things look ok. For me the first few months were the hardest but things actually improved on a daily basis. I had ask my doctor about the house advancement flap and the y-v flap but because I needed 2 flaps they weren't an option. Pain wise I was lucky, I had a doctor who kept me in the hospital for a few days. They managed my pain really well. I really never got above a 5-6 on a scale from 1 to 10. Toradol worked really well. I was given narcotics too but only took 1/2 of one at bedtime for a short time otherwise I used ibuprofen. What's most important is to keep the area clean. That hurt a bunch because of the open wounds but my husband made sure everything was clean and he dressed my wounds for me. I ate a normal diet and took miralax. I still use miralax at bedtime but I take about half of a dose. I never had a manometry done. I had a failed LIS and my CRS didn't use Botox. It's just his personal choice. For some it works great. Honestly I was in such bad shape before the surgery I really didn't care what my butt looked like..... But it's not bad at all. I wish you luck. Suzy
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Re: 3 months post lis and fissurectomy

Postby asdf123456 » 14 Jan 2014, 21:27

Thanks for the info. I would be a vy advancement flap I believe. This latest round of botox definitely relaxed the area a bit, but wound is still there and it feels uncomfortable for many hours after bowel movements or sitting. I am a young guy so I was really hoping the LIS would just cure me for good. I think the flap procedure is worth a try because I really don't want to live like this anymore. I haven't worked out since the original hemmy surgery back in September of 2012. I also lost almost 20 pounds b/c I hardly eat if I can help it. Best of luck with the healing. Just curious, did you have any symptoms of stricture/stenosis after your hem surgery, or was it just the fissure(s)?
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Re: 3 months post lis and fissurectomy

Postby suzyljank » 14 Jan 2014, 22:34

I got the stenosis from the hem surgery I had many years ago. The narrowing developed over time. 7 years ago I got my first fissure which healed on it's own but it left a little more scar tissue. The next fissure didn't heal until I had LIS but it too caused scar tissue and by then I had so much scar tissue the area would not stretch at all. That's why the double flap was done. The surgery removed the fissure, a lot of scar tissue (but not all of it) and the skin tags. The new skin makes it possible for the area to stretch again. I have to dilate every few days for the next 2 years to keep the skin pliable but it only takes a minute. It kind of exercises the muscle. If you have any more question feel free to ask, I'll do my best to answer. Suzy
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