I'll quickly weigh in, too -
thisfissure is right - that if your AF hasn't healed by now, it's probably not going to. That's what my crs said, too (crs #3, I mean - and he did my surgery).
Only you can make the decision, but I'm not sorry I had the surgery. I wanted an end to the AF and the pain.
Best of luck to you and keep us posted. BTW, it sounds like your crs knows his stuff, IMO.

the only thing I would add is that you have to keep in mind that above all a CRS is a surgeon, so yes, their opinion is going to reflect that. My CRS has never said that a longstanding fissure has little chance of healing, even though she does believe in and perform surgeries. It is all very individual. And she will admit that just because she doesnt have anything left in her own toolbox other than surgery, it doesn't mean there isn't another answer. It just means she isn't aware of another answer.
over many years I have come in contact with a lot of fissure sufferers on different forums online. And there are many successful healing stories from people who have very longstanding fissures that healed by taking alternative approaches with different types of healthcare providers... naturopaths, acupuncturists, herbalists, nutritionists, etc. I don't mean in any way to second guess anyone who chooses surgery. It is obviously a viable and successful option for many many people. And it is also a choice that doesn't require as much in the way of time, expense, research, etc. The surgeon takes care of things for you. But there are other choices that are also successful, and not everyone is a good candidate for surgery. If a person has had manometry, as an example, and it is discovered their resting pressure is low to normal, LIS surgery is contraindicated and probably isn't going to help them anyway and leaves them in a higher risk category for incontinence, if not in the short term, then potentially in the long term.
Anyway, just some additional thoughts to share because i think it is important to remember that every case is different and every case has to take the whole person into account.

jr2 wrote:the only thing I would add is that you have to keep in mind that above all a CRS is a surgeon, so yes, their opinion is going to reflect that. My CRS has never said that a longstanding fissure has little chance of healing, even though she does believe in and perform surgeries. It is all very individual. And she will admit that just because she doesnt have anything left in her own toolbox other than surgery, it doesn't mean there isn't another answer. It just means she isn't aware of another answer.
over many years I have come in contact with a lot of fissure sufferers on different forums online. And there are many successful healing stories from people who have very longstanding fissures that healed by taking alternative approaches with different types of healthcare providers... naturopaths, acupuncturists, herbalists, nutritionists, etc. I don't mean in any way to second guess anyone who chooses surgery. It is obviously a viable and successful option for many many people. And it is also a choice that doesn't require as much in the way of time, expense, research, etc. The surgeon takes care of things for you. But there are other choices that are also successful, and not everyone is a good candidate for surgery. If a person has had manometry, as an example, and it is discovered their resting pressure is low to normal, LIS surgery is contraindicated and probably isn't going to help them anyway and leaves them in a higher risk category for incontinence, if not in the short term, then potentially in the long term.
Anyway, just some additional thoughts to share because i think it is important to remember that every case is different and every case has to take the whole person into account.

That's right, jr. Every individual is very different and has to assess his/her own circumstances, before deciding anything.

So if kegal exercises are recommended then I would assume squats are safe with no weights because you are doing the same thing

Hi there, just thought I'd put in my two cents. I actually just booked my LIS today, I have had a debilitating fissure for three months and I've tried it all. Like many others who've answered you, I have some pelvic floor dysfunction also. I have problems evacuating even soft stool, and my straining/frequency of bowel movements (from ibs) are probably what caused the fissure initially.

My CRS is well aware of these other issues, but insists (and I agree) that we have to take it one step at a time. She is going to do the LIS to allow sphincter relaxation and then send me to pelvic floor physiotherapy to get my bms in order and prevent reoccurrence of a fissure.

I should add that I'm a young woman (24) and have not had children yet, so I'm not an ideal LIS candidate - but even with all this in mind, my surgeon and gastro were both very confident that this will be a positive next step.

I hope that this helps you a little in your decision - I know how hard it is to have pelvic floor issues along with fissures, it makes going to the bathroom hell on earth. I too am scared about bowel movements post LIS - but I figure they can't be worse than they are now.

Sending you healing thoughts