Hi everyone,

So I had been dealing with my anal fissure for over a year and had tried all the conservative methods. Many board members here seem to have had some success with self dilation so I thought I would give it a try (slowly, gently). At first it didn't seem to do anything, then I felt like I was having some success and then... well, for the most of the past week I have been experiencing leakage post bm. I am not certain whether this is related to the use of the dilators or not.

I am definitely afraid I may have overdone it however. I got the Vuvatech dilators which are supposed to be unisex, for anal or vaginal use (and indeed comes with instructions on each). There is a slight tapering at the front for insertion and a flared base at the end for safety, but otherwise the diameter is the same for the length of the device. I have since learned that this is more appropriate to a vaginal dilator.

It came in a set of 5 with different diameters. The .5 inch diameter did not seem to do anything. The .75 inch diameter took a little time getting used to, but was eventually able to fully insert. I then (after about a month) began using the 1 inch diameter dilator (with a length of 4 inches) and was also eventually able to get this just about fully inserted.

For the past few weeks I have been experimenting with the second largest size, the 1.25 inch diameter size, but have never been able to insert this fully and have never forced it. However I would attempt to use it after doing a session of the 1 inch diameter (usually about 10 mins for the 1 inch and 5 mins for the 1.25).

Of course would always use plenty of lube, and never experienced any pain for bleeding (though sometimes a feeling of dull soreness).

Did I mess myself up? I am seeing a CRS I have seen before on Friday. I am hoping for reassuring news but am fearing the worst, especially since I underwent this without supervision. On the other hand, I feel like people actually do this to prep for anal sex? On the other other hand, I have read in more than one place that anal sex does increase one's risk for leakage issues such as these.

Does anyone have any thoughts or has anyone experienced sometime similar? In retrospect I would not moved beyond the second size, since that seems in-line with the milometer-based sizes I am seeing posted here elsewhere.

I would not be so quick to worry that you've caused permanent damage. You are correct that tapered dilators are more appropriate for anal use (see Dilatan dilators). I've been using dilators daily for a few weeks now, and I'm currently on 27mm, and may move to the largest size of 30mm, if my PT says it's ok to do so. I would suggest a visit to a pelvic floor PT who has treated patients with fissures before. I hope your CRS has good news for you. Let us know how it goes! Take care.

Thank you very much for your response, Patience and Healing. I was miraculously able to book an appointment with my CRS for tomorrow (miraculous in terms of the turnaround time) and I will absolutely come back and report results so that other folks coming across this will know either to (hopefully) not worry if encountering something similar or (hopefully not) to absolutely not do what I have done. I am mentally prepared for an inconclusive result tomorrow as well (as in, CRS isn't sure and I will need to do manometry or something). I do have a bit of an anxious side (I gather not unusual for us fissure sufferers) so I'm hoping my worst-case anxiety on this is just that. I will definitely let everyone know.

How did things go at the doctor BrooklynButt?

Hi there Patience and Healing. Very sorry for my slow response to this, I actually had some trouble signing on to the board for a bit. The news is mixed-but-good. The *very* good news is that, as you had suspected, I had not caused any permanent damage. Sphincter tone per my specialist was "normal" and symmetrical, so it appears I had scared myself rather than really hurt myself (not the first time that has happened). So no permanent issues *phew*

The bad news is that my fissure is still active. Having tried many conservative methods, including two lengthy courses of diltiazem and my own attempt at dilation detailed above, my specialist has recommended botox for me. I am going to go along with it - I know the results are mixed but it seems like something to try prior to surgery. Thank you very much again for checking up on me (and for replying to my initial post when I was scared). I apologize again for taking so long to get back on here.

Hey no need to apologise. The forum was totally down and no one was able to access it for a long time. I'm glad to hear that the doctor said you haven't done any damage to your body. It's good that you're taking the step to try botox, at least it's something to try before going under the knife (if that's even necessary eventually). One thing I would ask the doctor about is whether you actually have a sphincter spasm. Anterior fissures are sometimes 'low pressure' and in that case the traditional LIS surgery might not be the right choice.

Thank you very much for that tip regarding anterior fissures and the fact that they are not necessarily correlated with high sphincter pressure. I am definitely going to add that to my "Question List" should I need to discuss the LIS option with my specialist (which I would of course like to avoid if possible but which I am also mentally preparing myself for).

A good BM is 1.5 inches or more, so that should be safe. I saw a medical article that said to dilate to 2 inches (sorry, I didn't save the reference). If I remember, the discussions about Lord's dilation indicated it did not necessarily heal the fissure, but provided relief from the pain. One of the problems (IMO) with the original procedure was that it used fingers; hold 4 fingers together and imagine pushing into the anus--where they're attached to the hand is not only much wider, it's far from circular, stretching the muscle unevenly. Dilators seem like the no-brainer solution, so I don't know why Dr. Lord and followers didn't use them (or instruct their patients to use them).