Hello Group,

I had a repeat botox injection done a little over a week ago and, unfortunately, my fissure symptoms have only worsened over the past week. I have had botox two times prior, which seemed to help with the fissure symptoms, but the fissures recurred shortly after the injections wore off. This time, it does not seem as though the botox is having the same effect as before and the only other option would be to have LIS. I have a very severe chronic pelvic floor dysfunction, which includes chronic levator spasm as well as pudendal nerve issues and I believe it is this underlying condition that has led to the development of fissures in the first place and that is interfering with the healing of the fissures. Because of this, I am very concerned about having the surgery as I am not sure whether LIS would even work for me given all of my underlying issues. I have been told in the past that I do not have an abnormally high anal resting pressure and that is also a concern since I am not sure that the fissures are the result of an overly spastic sphincter. I do not have any issues with constipation as I drink lots of water, consume lots of fiber and take miralax twice daily. I do, however, have major issues with my bowel movements because my muscles do not relax properly and I have difficulty passing stool and completely emptying my bowels.

Anybody have a similar experience as this and do you have any opinion on whether LIS would still be a good option for me? I'm literally at my wits end and don't know what to do. I am on disability and can only lye in bed all day. I hardly leave the house because standing and walking is very painful from the fissure.

Hi Mysorebutt,

I think I have the same condition too.I had tailbone pain aswell.
But when ever I sit ,next day i find my anal sphincter becomes tight and then causes fissures.I got fissure for the first time after I had a few months of discomfort in sitting and then I underwent LIS too,it seemed to help but whenever I sat the pain was back and so was analtightness.Later found my tailbone was dislocated ,now even after the tailbone is gone,I still have same problems.
I guess we must find which nerve is responsible for tightening sphincter(inferior rectal nerve goes to internal anal sphincter)

I just started seeing a pelvic floor physical therapist. Supposedly they can help with chronic spams which is also my issue. You mights also try a urugynocologist (if you’re a female) as they also deal with pelvic floor dysfunction. My CRS works in conjunction with one and just gave me her info today. I am going to try a repeat Botox plus the PT and uro and my CRS feels a combination of them all may help me get better without LIS. Good luck.

Hi Can takkar,
Spasms ,are they contractions like switch on off or pulsating or it is always contracted ?