Relapse. Scheduled LIS

never going to heal

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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Relapse. Scheduled LIS

Postby backagain » 05 Dec 2013, 16:46

I have been suffering with a fissure on and off for three years. The first year was just here and there and it would heal. The second year it was more frequent, but again, bearable. The past year has been awful. I am a 26 year old female and my quality of life is terrible when this thing is acting up. I can't run or exercise and every day of work (mostly spent at a computer) is excruciating. Last November I had a botox injection (after all the useless creams of course). I also do not have hard stools or constipation or diarrhea, so really don't know why I have this issue in the first place. The botox made it much, much worse. I think from the stretching involved in the procedure. After the botox, I developed a large and uncomfortable skin tag. I could feel the botox "working" in that the area was noticeably more relaxed, but it didn't heal. So, I gutted it out and waited until the summer to have another round of botox and a fissurectomy. I had that procedure in July and it wasn't bad. I felt better after 3-4 days of pain and then was probably 99% healed after a month. So, August, September, October, and November passed and I had my life back. I could run and lead a normal life without pain. Then, a week ago, my fissure came back. Same place. It's bad. I literally can't believe it's happening again. I saw my doctor. He thinks the botox has worn off and that's probably why it's back, which tells him that it heals when the muscle is relaxed and that I really need the LIS procedure done to heal it for good. I'm so nervous and have avoided this for so long because I'm afraid of incontinence. I'm just looking for opinions of people who have actually had it done (good and bad). I'd really like to hear from women and specifically young women. One thing my doctor told me is that it's not an ideal procedure for a woman of childbearing age because I could be fine after the procedure and if/when I have kids later, I could be at an increased risk for incontinence following a delivery because of the already weakened muscle. I just don't know what to do. I know I need the surgery to not have a fissure, but I have to think a fissure is better than wearing a diaper or farting in meetings all the time. I just don't know why there isn't a better option. Help please. I'm so discouraged and frustrated.
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Re: Relapse. Scheduled LIS

Postby Loves Tennis » 05 Dec 2013, 18:09

Hi Backagain........so v sorry to hear your fissure is back, God don't I know that feeling, it is utterly depressing, no one knows unless they have been thru it. My advice is go for the LIS, find the best surgeon, ask around, ask other patients, it took my years of trying and 4 attempts at botox to finally find the right guy, he said I would have never healed and it was obvious I needed the LIS, I had it 2 months ago and my life is changed, I actually enjoy going to the loo again, and no incontinence at all, no farts slipping out. It's wonderful. I only wish I had one it years ago, where are you based I am in Ireland and had the surgery in Dublin.........amazing surgeon. Wishing you the best of luck !
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Re: Relapse. Scheduled LIS

Postby backagain » 05 Dec 2013, 18:18

Thanks for the reply and info! How long was your recovery? I am in the US-- in Maryland. I trust the doctor just mostly concerned about the future with someday wanting to get pregnant and have children. Just scary to think about incontinence now or in the future. But I can't live my entire life with a fissure either!
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Re: Relapse. Scheduled LIS

Postby Loves Tennis » 05 Dec 2013, 18:32

I completely know where you are coming from......I pondered for months....and really dreaded the thought of something going wrong and being left with leakage probs. I recovered quite quickly, the following day after the surgery I went to the loo for the first time and the packing that they put "up there" slipped out easily, I literally had no fissure pain after the first BM and it' didn't hurt, I was just tender and sore a little at the incision site where there was a stitch or two. four days later I was out for a 2 mile walk and within 3 days I stopped taking any painkillers, I had taken them for first 3 days but hardly needed them. After about 3-4 weeks it just got itchy good sign as it was healing. I had my check up with the surgeon last week and the incision site is nearly healed , the fissure is beginning to cover over with scar tissue but it still technically there (he called it a crater!!!) but nerve endings are cut to it so NO PAIN........I am past having kids as I am 50 with grown up kids so can understand your concerns for the future but I think the surgery to change your life NOW is worth the risk, you cannot live your life with a fissure it's an awful way to spend your life.........I did it on/off for 4 years and luckily had the most amazing understanding husband and family....any other guy would have walked I was impossible to live with, I could do nothing Now I am back hill walking, just need to get back to tennis now.......that will come next year. I wish you lots of healing and luck VIv
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Re: Relapse. Scheduled LIS

Postby jr2 » 05 Dec 2013, 19:09

I'm not able to have LIS for other health reasons, so I'm not in the same boat, but I wanted to jump in on the concern about incontinence now and later. It is a really tough decision. Yes, there is a risk. The risk is pretty statistically low, particularly low for incontinence to stool. Even if there is some incontinence to gas initially, it usually resolves over the course of the first year as the sphincter muscle does regain its strength over that period.

As far as the future, there is no way for anyone to know what the future holds. We only know what we've got in front of us right now. With a pregnancy though, you would have options. You could have an anal ultrasound as well as a pressure test of the sphincter muscle performed to check out its health and strength at the time of your pregnancy. If it looked as though there was any question about further damage with a vaginal birth, you could have a C-section. Sure, it's not ideal. But you have a life to live now. Your life isn't in the future. And it sounds like you don't feel your life is very ideal right now.

It is always a good idea to get a second opinion from another surgeon, not because you don't trust the one you have, but because fresh perspectives can either confirm what you already have heard, or provide you with other options to consider.

Good luck with what you decide!
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Re: Relapse. Scheduled LIS

Postby Savaici » 05 Dec 2013, 20:59

Always such heartfelt and excellent advice from jr2.
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Re: Relapse. Scheduled LIS

Postby Bettyblue » 08 Dec 2013, 10:25

I am agonizing like you with the idea of a LIS. I have only 30 years old and back in my mind ideas of incontinence , children, etc, etc.... But as somebody here said we can not live in the future. Think that right now in the state you are, you can not get pregnant or have children either. I have an excellent CRS and he has told me that incontinence is the out come of a very bad surgeon, if the LIS is well done incontinence will never be a problem. I also asked him about pregnancy and he told me it will be no a problem in the future. He is so confident in the LIS and have assure me that after 15 years of experience he never had had a case. I don't know what to think, so many different answers for one question. If I decided to go with LIS I will do it with laser, is more gentle with tissues and the pain and recuperation time is less. But as my CRS told me " It does not matter if is done with laser or in a more conventional way, the most important thing is the hands of your surgeon". Do your research and chose some one with a lot of experience. Good luck.
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Re: Relapse. Scheduled LIS

Postby backagain » 08 Dec 2013, 16:44

Thank you all for your kind words. I know it's something i need to have done and just hope for the best. Thanks again.
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Re: Relapse. Scheduled LIS

Postby backagain » 27 Dec 2013, 08:19

Well today is the day. But I backed out of getting LIS and have switched my procedure to another round of botox and fissurectomy. I guess just giving it one last shot before LIS. If it weren't for wanting to have children in a few years, I would just go ahead and get LIS. Keep your fingers crossed this will work!

Thanks to all for your kind words.
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Re: Relapse. Scheduled LIS

Postby owmybum » 27 Dec 2013, 08:37

Good luck...... My fingers are crossed this will fix you once and for all!!

OMB x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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