Synphcterotmy 3x??

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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Synphcterotmy 3x??

Postby Harper05 » 29 Jun 2017, 15:36

So six weeks out from surgery number #2 and I'm still in pain. Enough pain that I know it's not normal.
I had my first surgery in jan with crs #1.
Had my second in May with crs #2.
Still not healed and and crs #2 says the fissure was probably so large it's just not healing so now he will cut on the other side.
Who has 3?????
He's said since he didn't do the first he's not considering it a surgery.
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Re: Synphcterotmy 3x??

Postby VictorianKnight55 » 29 Jun 2017, 21:50

Hi Harper,

Very sorry hear about that, was hoping for some good news regarding your recovery.

There are several people on here who had two sphincterotomies (opposite incisions), but I don't know about a third one.

Are you absolutely sure its pain from the fissure and not the incision site? If so, are you sure that the incision site has healed yet to consider a third sphincterotomy?
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Re: Synphcterotmy 3x??

Postby Harper05 » 30 Jun 2017, 13:07

well the pain this week has been just as bad as pre surgery, so I know its not right. The CRS gave me an exam and it is just sore by the AF, he said the incision site looks good.
So the two times I had it done it was on the same side. I'm wondering if an incision on the opposite side (AF side) will help it heal. Most people that get a second one done is it opposite sides?
I am skeptical about getting it done again, but I know creams wont work.. and I don't want to live in pain anymore ;/
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Re: Synphcterotmy 3x??

Postby VictorianKnight55 » 30 Jun 2017, 16:00

I know how horrible and disabling AF pain is and I know that I would do anything to make it go away.

But it is unusual what your second surgeon did in that he operated on the same side as the first surgery. But good thing that the incision sites have healed so if he or she decides to do a third one, they can do so with ease.

On another note, is an advancement flap an option for you?
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Re: Synphcterotmy 3x??

Postby Harper05 » 30 Jun 2017, 19:32

He said that could be an option but it's more invasive... should I consider it?
He said he did it on the same side because he didn't see any incision or scarring from the first surgery....

And yes pain is terrible, and I just want it to go away...
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Re: Synphcterotmy 3x??

Postby VictorianKnight55 » 30 Jun 2017, 19:55

I see, that makes perfect sense.

Based on people's experiences i've been reading, an advancement flap is more invasive. So what you are saying is that you're surgeon is giving you two options: a third sphincterotomy or a flap.

Whichever option you choose, be sure to ask him or her everything that is on your mind: potential complications, healing process, how much muscle will be cut, etc.

Do you know the extent of your first and second LIS? As in how much muscle was cut? That in my opinion is a very important question because the more muscle is cut, the higher the rates of incontinence to flatus and rarely liquid.

Have you considered telling your surgeon to refer you to have an anal manometry test? I haven't had one but it shows you what your squeeze and resting pressures are in mmHg. It gives you a very useful preoperative assessment especially to someone who had more than one sphincterotomy.

The higher your pressures are, the lower the risk of incontinence after surgery. The lower your pressures are, the higher the risk of incontinence after surgery.
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Re: Synphcterotmy 3x??

Postby Harper05 » 30 Jun 2017, 20:04

So I asked him about incontinence and he said most peoooe do not have a problem.
I asked him other alternatives and he said the advancement flap, he didn't really give me the option he just said it was more invasive.
I didn't ask how far the cut was; but it's something I should as well as anal manometry test..
I'm just so anxious to get this healed. But i know I need to do my homework.
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Re: Synphcterotmy 3x??

Postby Harper05 » 30 Jun 2017, 20:08

I'm reading about advancement flap, is it commonly used for fissures or mostly fistulas?
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Re: Synphcterotmy 3x??

Postby VictorianKnight55 » 30 Jun 2017, 20:30

It is used for both. Think of it as a reconstruction of the anal canal.

Best of luck and please do update us on your progress. I know it's difficult going about life in pain, and unfortunately some doctors don't show that much empathy to our condition. With all due respect to all hard working doctors, but there are some who I am sure are in the minority who deserve to be punched in the face repeatedly for showing zero sympathy and understanding. No doctor will understand unless he or she went through the same kind of pain.
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Re: Synphcterotmy 3x??

Postby Harper05 » 02 Jul 2017, 13:09

will do..

Do you still have some bleeding? I do occasionally. and i def still feel the fissure.. the pain is unreal sometimes!
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