Second LIS and/or fistulotomy three months post op

Nonhealing wound

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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Second LIS and/or fistulotomy three months post op

Postby horsetrainer » 15 Nov 2016, 18:47

I had LIS (open) on August 22, 2016. It's now mid-November. Good news: my decades-old fissure healed in two months! Not so good news: my incision has never closed. It also has never stopped hurting. Now it appears that it might be infected, with severe pain, green discharge, and a low fever.

I have seen my colorectal surgeon three times in the last two weeks. He applied silver nitrate to the wound to remove granulation tissue and encourage healing. The pain from the silver nitrate was appallingly intense. I endured these office procedures because it might help.

The LIS incision sort of turned into a fissure, so I traded one cut for another. I do not regret having the sphinterotomy, I am really glad I did it, I just happen to have had bad luck. I asked him how often he saw this, and he said less than 1% of the time. It made me wonder if that means that I am the first, as he is on the young side! But he is very intelligent and has a lot of experience.

Yesterday my pain hit a new level and I rang the doctor. Today he examined me carefully without a full digital exam and said that he will do an exam under anesthesia this week, and try to figure out whether there is a fistula, abscess, etc. He will also evaluate the internal sphincter to determine whether I need a second LIS. If he does this, he will do it on the right side. The current (non healing) incision is on the left.

There will be additional risk of incontinence, but I told him I trust him. He said he won't divide the sphincter if he feels that it would make me incontinent, but if it "feels tight" he will do the second LIS. I think that with anal fissures most of us get to the point where we can't take the pain anymore and we are willing to risk incontinence because our quality of life has diminished.

I gladly took the oxycodone he prescribed today. It is potentially constipating, but if I take Miralax I can manage it.

Stay strong, everybody! I will update after I have the procedure, at the end of this week or the beginning of next.
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Re: Second LIS and/or fistulotomy three months post op

Postby Mypoorbutt » 16 Nov 2016, 03:03

Good luck, that sounds awful really hope something works for you as no one should have to live like this it's just horrendous.
I had LIS last week and yesterday spent 24 hours in total spasms, thankfully they have eased off now but I agree there comes a point when every other consideration is secondary to how much pain we are in.
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Re: Second LIS and/or fistulotomy three months post op

Postby Mommylife » 19 Nov 2016, 22:33

What is your update now? Did they find what was wrong?
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Re: Second LIS and/or fistulotomy three months post op

Postby Mommylife » 19 Nov 2016, 22:36

I'm
Fixing to have an open LIS, should I demand it be a closed one? I had a Hemorrhoidectomy three months ago and developed anal stenosis and anal fissures. My surgeon said it needed to be an open LIS surgery
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Re: Second LIS and/or fistulotomy three months post op

Postby Mypoorbutt » 20 Nov 2016, 06:45

I think your surgeon knows you best mine was closed as I can often go to the toilet 10x a day....which with an open LIS would easily cause infection, it's been 2 weeks now and to be honest I haven't noticed much difference at all the fissure is still very active and I'm still having to force wind out so no noticeable loosening of the sphincter but I will see what my CRS says in another 2 weeks.
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Re: Second LIS and/or fistulotomy three months post op

Postby Mommylife » 20 Nov 2016, 09:10

I'm sorry you see no difference. I'm starting to think, if the surgery is really needed. Or can I live with this condition, the rest of my life. How is your pain level as far as surgery goes?
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Re: Second LIS and/or fistulotomy three months post op

Postby Mypoorbutt » 20 Nov 2016, 09:25

The pain from surgery seemed to go about day 10, but I have lots of other bowel issues that are probably having an impact on what's happening. I will be phoning my surgeons secretary one day this week to see if I can have a chat as it's getting increasingly uncomfortable.
You don't need to live with this surgery works great in 99% of cases no one should have to live in pain
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Re: Second LIS and/or fistulotomy three months post op

Postby Mommylife » 20 Nov 2016, 12:00

Thanks for the response. I'm just scared to death because it's going to be an open LIS but the surgeon said she would probably have to leave it open because of all the scar tissue from my previous hemorrhoidectomy. And from all my reading I've done having an open LIS is way more painful higher risk of infection etc. ugh. And I have two small children. So just taking it easy, is not an option for me after a week.
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Re: Second LIS and/or fistulotomy three months post op

Postby Mommylife » 20 Nov 2016, 12:01

Another question, did you have a special diet to follow or did you resume normal diet? my doctor told me just to resume my normal diet and I'm like that doesn't sound right, I should be like on a very liquid high-fiber diet for a long time ?
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Re: Second LIS and/or fistulotomy three months post op

Postby Mypoorbutt » 21 Nov 2016, 03:39

It's hard for me to answer that as due to my Crohns and IBS I do t eat a normal diet anyway. But I was told to try and keep things soft but not too soft.
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