Hi, I am new here- but I've been reading many posts. After going to 5 different doctors and having (painful) anoscope, colonoscopy, and even ct scan, finally referred myself to CRS. He barely touched me- and me yelling in pain- immediatley diagnosed me with fissure and said I needed surgery. I asked about other treatments- he said in his opinion- the cream causes so many headaches and oftne people end up in surgery anyway and he wasn't too fond of the botox idea. He was very arrogant but knowlegable- elderly man and has written several books about the subjuct. I am very scared. he said he would genlty cut away the scar tissue and some muscle fibers to help it heal. He said recovery is quick- but I;m not stupid. Do I need to ask for pain meds? Please help, I am scared. he called it proctoplasty from fissure and anal stenosis . please help

forgot to mention- this started 3 months ago after a (not needed) round on antibiotics. I feel irritation/pain all day long. I i have a solid bm, it feels like giving birth out my butt. Is it normal to feel this all day long? It seems like most people only have pain after bm.

Hi,
Welcome, but so sorry you are here!

I'm not familiar with proctoplasty. That sounds more like a advancement flap procedure?
He said he would cut away some scar tissue but no mention about pulling skin over to cover wound?
When I am more sore, I feel it all day. It's because of the inflammation. I have to be careful how I sit and not get up and off of seats too quickly so as not to pull my butt cheeks. -sigh-
Have you got your BMs under controll, aka consistently soft so not pushing or straining ever? You want to make sure of that before you get any procedure done.
Sounds like you have seen a lot of docs but a second opinion from a crs wouldn't hurt. Plus you can look up the doctors' reviews on sites like ratemds.com.
-Tanya

Hi Tanya- thanks for the reply. I have been using Miralax daily since my colonoscopy- and it does seem to help. I have looked him up= his rates were mostly very good- he doesn't have the best bedside manner- though to me he was pretty nice- maybe because I am a young female? He was very aragant- not demeaning to me- but I got the idea that he thought the other doctors I'd seen were idoits for making me go through an anoscope and colonscopy. (Neither doc said they saw anything in except inflammation during the anoscope). I kind of would like to see another CRS but we have no insurance and my husband thinks I worry too much.

Well I kinda agree with him that your other doctors do sound like idiots... :)
I hate it when doctors are arrogant though. I have a knee jerk reaction of not trusting them for some reason when they behave like that.
You might like to get a better idea of what cutting away the scar tissue means. Is a proctoplasty the same as a fissurectomy? Or is he just talking about tidying up the edges of the fissure to help it heal faster?
The CRSs around here (BC Canada) believe fissurectomies don't promote healing. That the relaxing of the muscle by LIS or botox or Dilation, and the consistency of BMs are the important parts.
Tough decision I'm sure. And expensive. But better to be poorer but healed.
That's good,that he has good rates!
-Tanya

I don't know. I don't feel as comfortable hearing your story that your doctor wants to jump right to surgery without even giving a topical medication a try first. Nifedipine or diltiazem can both be used without the risk of headache. I can only tell you that if it were me I would want another opinion from another CRS.

Tanya-
His words were that he would gently removoe scar tissue and cut away some muscle- as little as possible. He's very knowledgable but I'm scared. My husband trusts him- maybe it's just beacuse it's my body and I'm nervous. Though the last two days I've been feeling really well- only slight twinges now and then. Time will tell. Honestly, maybe I won't need it- maybe he'll look and see it's healed. Is it possible for scar tissue to cause that irritating cut feeling?

IMO I would get another opinion. It is just the sensible thing to do before committing to surgery.
I guess I don't understand the terms this CRS uses and I'm not sure what he means by 'cut away' muscle tissue. An LIS doesn't remove muscle, it just cuts into it a bit.
I would get him to clarify what he means. Then you would have a better idea of what's on the table, so to speak.
Another opinion will give you more to think about and I find things are less scary the more knowledge you have.
-Tanya