i've had an AF for over 6 years. had botox and skin tag removal 2 years ago, but the botox didn't work.

i wanted LIS, but surgeon said the NHS avoid doing it on females because of the risks.

he checked my fissure and said it wasn't that bad / looked to be healing but needed a closer look with camera. but since it was too sore, he said he'll check when i'm under anesthesia.

so i'm booked in for another surgery. so after examination, they'll either do botox again if cut is not that deep. however if the fissure is deep, they will do advancement flap surgery (which i'm really afraid of). so basically i'll only find out what they've done after i wake up. eek!

few questions:
what is the aftermath pain of advancement flap surgery? and how quick to recover?
what is the success rate of advancement flap surgery?
could botox work a second time around after failing the first time round?

Hi so I've been told and read the for some people it takes a second round of Botox to sort it out I'm a female an had Botox nearly 3 weeks ago hoping this fixes it I'm still having some pain at the start of bms but no pain during or after

Hi I went to 3 different CRS’s on the NHS who all refused to do LIS on me. So I paid for a private consultation with a CRS who specialises in IBDs (I have crohns). He agreed to do LIS on me.
You are entitled to change hospitals I had one hospital that point blank refused LIS to women and 2 that would have done it after 2 rounds of Botox if I didn’t have Crohns
Yes the recovery from advancement flap surgery is longer than LIS. One of the moderators on here had it...suzyjank...if you search you will find her diary.
Most people who have advancement flap have it after LIS hasn’t worked for them.
Or they have a low to normal resting pressure so to do LIS would be risky.
My advice to you would be to ask for a resting pressure test at the very least or to speak a second opinion.
How bad is your pain and are you getting spasms
Good luck

Mypoorbutt sorry to just in but as you know i don't have alot of pain an don't get spasms would your advice be keep going with the Botox even a second round if I need it? I mite pay to have my tone checked but I don't understand how it works if the fissure is sore isn't the muscle going to be tight an give a false tight reading during the test?

The anal manometery test rarely goes a false reading. The test is pretty simple if slightly uncomfortable. They insert a tube with a small balloon on the end which is inflated to test neural reactions
It was explained to me and as I can remember I was told that even though I can pass and do pass quite large stool without difficulty that doesn’t mean my resting pressure is normal. It relates to the tone of the IS when it’s not in use, this is determined by many things including genetics, hormones and stress.
If your not getting spasms then it could be that it’s not deep enough big enough or in the place to set them off

Ok so it doesn't mean because I don't get spasms I shouldn't get lis, I'm sticking to Botox for now but you never know I feel like my fissure an it's pain isn't bad enough for lis? Or do people just passing glass daily get lis too?

I had Botox 4+ weeks ago and it didn’t work. I am scheduled for a second round, but had to wait 3 months in between to make sure it’s all out of your system. My dr prefers to try a second Botox before surgery. He is going to put in more Botox, so it has a better chance of working. I had an exam under anesthesia during the first Botox, including having a camera placed up there, and it made my fissures much worse. I still have not gotten back to where I was before the procedure. The next time he will just do the injections. I am praying it works and wondering how I’ll get through the next two months.... Good luck and hang in there. I don’t know what NHS is. I am in Florida.