by Deleted User 5 » 04 Dec 2007, 13:13
Hi NW, and welcome to the board! Sorry you're in such straits, but then, you wouldn't be here if you weren't!
When you say fissurectomy, you "probably" mean the LIS (Lateral Internal Sphinctorotomy) which is the most common surgical procedure performed for anal fissure. While there is a "fissurectomy" type procedure, it is not common and may not even be reliable.
LIS involves making a lateral incision across the sphincter, which prevents it from
spasming. The sphincter spasms are what causes the clenching type pain that can last for hours, on and off, after a person with AF has a bowel movement. These same spasms are also the primary reason why the fissure will not heal, because the tightness prevents adequate blood flow to the fissure site, preventing healing. So once you have the LIS surgery, two good things happen: 1) you no longer have the clenching spasming pain, and 2) the fissure can begin to heal (but it will still take the fissure 6 weeks or longer to heal).
I had the LIS one year ago. While the recovery *was* rough, it isn't always as rough for everyone. I was back at work in a week and a half, but I didn't feel *normal* until a month had passed.
When you first "wake up" from the surgery you may have a lot of pain ( I was given pain killers in the hospital post-surgery so I didn't suffer at all), but it quickly dissipates to more like a dull pain, nothing as bad as the fissure pain. But like any surgery, there is residual pain from the incision, which gets a little better day by day. After a week, you just have a weird feeling down there like a strip of leather is up your tail. That goes away, too, in about another week.
If your fissure is deep, then it may take it a bit longer to heal after the surgery. This means you may still have some pain *during* a BM and some bleeding. But the spasming pain will be gone! And slowly, day by day, the fissure will begin to heal and the bleeding will decrease until one day you are "primarily" healed (although it really takes much longer for the fissure to be completely healed, maybe even a year.)
My first question is, what type of pain do you have. Is it just during the BM, or for a period of time after the BM?
Also, many people fear the surgery because they are so afraid of it making them incontinent, but the risk for that is extremely low unless you are elderly or morbidly obese (there may be other risk factors I don't know about).
The LIS has a 97-99% success rate, much higher than other more conservative treatment available.