Recent LIS - please answer

Concern abut incision area

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Recent LIS - please answer

Postby Worrier12345 » 14 Nov 2014, 06:56

Hi all,

I had LIS on Monday. Things haven't been too bad since - minimal pain and only a little bleeding/discharge. However I am rather concerned about the state of my anus post-LIS and was hoping that those of you with experience could offer some advice. I did not see the surgeon after the op and have had problems getting hold of him so you guys are the next source for info.

The issue I have is that, where I assume the incision was done (left side, slightly towards the anterior) there is a sort of dent. It's not really a hole, since there is skin there, it's more like a little crater located within a fold of the flesh. The problem is that this gets clogged with stool, and I have to spread my anus apart to clean it. It takes a while to clean and is tender since this is where the incision was, also after cleaning it more stool seems to leek out and I have to go through the process again.

My concern is that this issue is not going to go away. I don't know if the 'crater' will fill in as it heals, but if it doesn't cleaning after a BM is going to be difficult for the rest of my life. I'm only on day4 post op so I know I have a long way to go - but I'm concerned that is bad early sign.

Any ideas what's going on here? Did anyone else have a similar issue at the incision site? Did the problem get better?
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Re: Recent LIS - please answer

Postby Worrier12345 » 14 Nov 2014, 13:21

Having read up on this I am now concerned that I am developing a 'gutter deformity'. It seems logical to me that the incision wound is not healing properly and has become a crater - this is both trapping faeces and causing some soiling.

It worries me a lot since I've not heard of anyone on this forum describing their incision site like this. It's definitely like I'm missing some flesh in the anal cushion where the incision was done. Will this fill in?

I really would appreciate any advice from you guys as I'm getting stressed about it.

Many thanks.
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Re: Recent LIS - please answer

Postby Worrier12345 » 14 Nov 2014, 15:09

I know I'm living up to my name here but the more I read about it the more I am convinced that my LIS has resulted in a keyhole deformity. When I first looked at the area after surgery I thought the the incision site was a little higher than I expected - I thought it would be exactly at the 9 o'clock position whereas mine seems more like it is around around 10 or 11. The crater that has formed goes from this area to the top of my anus at the anterior (which is where my fissure us located). When I part my cheeks to see the anus properly it looks like the 'keyhole' shape where this complication gets its name.

I am now petrified that this is what has happened. I won't be able to get hold of my surgeon until Monday now and I really having trouble dealing with this.

Sorry for ranting but I'm feeling really down about this. The thing is - I'm pretty sure the lis was a success. BMs have felt much better since. But now I feel like I'm either facing a lifetime of leaking and soiling or another surgery to correct it. Not really what I was hoping for 5 days after surgery.
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Re: Recent LIS - please answer

Postby asdf123456 » 14 Nov 2014, 21:17

I wouldn't jump to any conclusions based on self-inspection, especially 5 days post-op. It's certainly possible that the trouble cleaning you are having is just from scarring that getting poop stuck to it during BMs. That is very common. It's also possible that the "keyhole" you are seeing is perfectly natural and may even have nothing to do with surgery. If you had LIS 5 days ago, how is it possible that you can look right at it the surgical site and notice the "keyhole" anyway? Isn't there a radial wound across it where the scalpel entered?

Also, I didn't wipe with paper for at least a month after my surgery...were you given a sitz bath or anything like to that to wash off instead? I can't imagine wiping so soon after a surgery.
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Re: Recent LIS - please answer

Postby Worrier12345 » 15 Nov 2014, 13:10

Thanks for the reply adsf. After yesterday's meltdown I'm feeling a little more positive.

I'm certainly experiencing problems cleaning after a BM and stool does seem to be getting stick and oozing out after I have cleaned up. As u previously stated, I am still worried that my anus just doesn't look right - it seems to be swollen everywhere BUT the incision area. Anyway, I'm hoping in a few more days the swelling and bruising will disappear enough for me to see what's going on properly.

I have the usual fears that the surgeon has cut too much or in the wrong place etc and this will leave me with soiling issues for the rest of my life. I know the chances are small but it's not been easy for me to shake these worries.

Thanks for the reply. I'll try to calm down and get on with recovering. (Expect some more frantic worries from me shortly...!)
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