My Doc (crs) said that women have more difficulty healing from fissures on the anterior or front side of the anus. He seemed mystified by this (not very reassuring since this is what I have).
Has anyone else heard any theories as to why this is?
-woi

:( sounds heartbreaking for us newbies- hope it not reality just his/ her opinion. What do u mean 12 o'clock? I feel so dumb/ I blame it on the chemotherapy that has really messed my brain :(.
But thank God - He is in control. Take care sweetie

Hey maria,
12 o'clock means the fissure is towards the genitals and 6 o'clock is towards the spine. I had to school myself on this, thanks to one of the boardies lol. It's not something I would have ever known until I got a fissure...

Workingonit,
My fissure was towards the spine. There are women in here who have had them in the front and had the surgery. I believe alpinestrawberry is one of them?! Hopefully she can confirm this as I'm not 100% sure.
I will take a look in some of the older threads and see if I run across others who mentioned their location who had surgery.
You could also get a second opinion on that. I know from reading in this forum that CRS's and their opinions vary widely... I went to two CRS in the same group and got to very different opinions...

Hey Workingonit,
mine was towards the front. It happened after childbirth and so it makes sense to me that it was closer to the vagina--that area would have been especially traumatized from the rigors of giving birth/having an episiotomy. At first I didn't know what it was. Once I figured it out and did some reading about it, the sources I saw seemed to suggest that fissures that develop after childbirth generally aren't due to the muscle being overtight, so if they don't heal on their own the surgery to use would be an advancement flap to cover the fissure rather than LIS.
Well at any rate the fissure seemed to heal just fine at first, and stayed that way for long periods of time, but eventually it would always flare up again. I think the pain of all the retears gradually made the muscle get tighter and tighter until finally after five years it was so tight I could barely go anymore, and at that point I was developing new fissures in different places left and right! I think there was just so much tension there that something had to give. Then I was able to have LIS last March. I have had a few episodes of retears since having the surgery, but oddly enough, none were at the original fissure site. I finally seem to be healing for good now (KOW)!
I'm not sure why your CRS is so concerned about it being in the front. The main thing to note is, is the muscle too tight? Because that dictates the surgical technique that would be needed to fix it. My CRS didn't express any concerns about fissure location, but then he could tell right away that my muscle was WAY too tight.
I know I've seen other posts on here where women had anterior fissures...I don't think it's uncommon at all (for women) or a reason to forgo surgery. That said, I agree with Dawn that CRS's are wildly different in their opinions sometimes. It's like there's no SOP when it comes to treating fissures. A second opinion couldn't hurt.
Hang in there, I really don't think this is as impossible to heal as your doctor suggests!

I've been reading other posts about the advancement flap surgery and it kinda freaks me out.
It has become such a small fissure that I hope there is a less invasive option. It seems pretty drastic for a small fissure, even if it doesn't seem to want to completely heal.
I have the names of another crs clinic in town, so if I don't like what the doc says next week, I will start a second opinion in motion.
Thank you so much Dawn and Alpinestrawberry for your insight! So glad you are recovering Alpine!
-woi