Well, I'm pleased to report that my appointment went well. The Dr was very understanding and said he didn't want to risk opening anything up again so just had a look from the outside, but yes confirmed that other than a skin tag (which doesn't both me) he couldn't see anything.
He explained things really well, including incontinence due to surgery, as that was what has stopped me seeking help up until now. He said the risks were that up to 10% may find themselves incontinent to gas and only 1% to fecal matter and that what that means isn't that all of a sudden you need a poo and oops you've poo'd yourself but that it's the internal sphincter that is affected and this has a resting pressure that stops us soiling ourselves and farting, but that our external sphincter is unaffected, so if we need the loo we can still hold things just as effectively. But we may get some mild soiling, i.e. skid marks by the end of the day and that's it. Not that we'd have a massive accident. Not ideal, but yeah I see not as bad as I had feared.
Anyway, because I've been managing ok he wants me to go back in 3 months and if things are fine then he'll discharge me, or if not then they'll look at what to try next, probably botox. He was concerned more about the fact that I won't let things 'open up' to go to the loo and suspects my fear of trying this is more me just being nervous than a physical problem. I'm not so sure as I've spent around 12 years opening things up every weeks or so, so I know what I can poo without doing damage. He said that it's easier to correct the fissure than it is abnormal toilet habits (I can't remember what he called this, but it had a name. If anyone knows that would be good???).
In fact just remembered he did say if there were more problems when I go back that the next thing would be an examination under anesthetic. If anyone could share their experiences with this I'd be very grateful. I think yeah great I'm under for it so it won't hurt at the time, but aren't they still likely to damage things and open things up again? I just know how difficult it is to break the vicious circle of pain, spasm and continually needing to poo making this all worse!!
The guy was very pleasant and reassuring though and knew his stuff. :)