Chronic anal fissure (4+ years) recently became infected and caused 2 giant abscesses and fistula, just weeks after I was FINALLY able to finally convince my surgeon to schedule me for LIS. Now, instead of LIS, I'm preparing for fistulotomy and cutting seton placement this Thursday (with a fantastic new surgeon...ditched the old one, to say the least).

Something just occurred to me though...I rely very heavily on the niphedipine and lidocaine to make it through the day (apply it 3-5 times daily or I'm in pain/itching/discomfort constantly). Will I be able to insert/apply these with a cutting seton in? Won't that be absolute torture, physically, to insert anything anally? I'm not sure how I'll be able to get through the next few months without those treatments available to me for my fissure....

Hi Gracie,
So sorry to hear that must be so frustrating...is there no way you can have the LIS at the same time as I know some people have the LIS with the fistulotomy. I can't offer any advice but can only empathise with you I have only been waiting 18 months for my LIS and am so terrified of it being cancelled.
Sorry I can't help more
Good look

They can't do the LIS now that they have to fix the fistula....can't cut the muscle twice (cutting seton will be doing that) and maintain continence. But, they shouldn't need to... Surgeon has assured me that if the cutting seton does its job, the cut will heal the fissure at the same time. It's essentially the same thing...a cutting seton just makes the cut slowly over time. PRAYING that's the case. I've been in misery these last 4+ years, as I'm sure you know. But, obviously it's going to take time...several months. I can't imagine not being able to treat the fissure in the meantime. I need to ask my surgeon...I'm just wondering if anyone else had experience with this same scenario. I hope someday this is all a bad memory. I hope your LIS goes well!!!!

Ah I see, yes you won't need two cuts...I really hope you can put something on there to help with the pain...maybe you can even if it's just on the outside to start with.
I guess at least it's now getting sorted and hopefully this time next year it will all be a bad memory and you will be living a pain free life like you should be.
I cannot imagine putting up with this amount of pain for 4 years 18 months have been bad enough. I truly feel for you that's it's had to get to this stage before you managed to be treated that is totally unacceptable.
Take care

Thanks! Yeah....tried both ointments and 2 rounds of botox over the last few years...nada. Surgeon was extremely hesitant to do LIS and it obviously has now led to infection and fistula so I'm beyond frustrated. Should have sought a second opinion long ago. Former surgeon is at a top-notch research hospital and even my current surgeon (who's literally the best in the state) says she's a good doc, but I think she waited way too long to offer me the LIS option and her bedside manner is the absolute WORST. I once suggested a new fissure surgery (kenalog protocol) I'd heard about being done at Columbia in NY and her response was to scream "THEN GO TO HIM!!" You live and you learn, I guess.

Best of luck to you. I'm sure everything will work out for you as well. :-)

Goodness that sounds awful hun, i know where your coming from hun i have tried the creams and had botox they wanted me to have another go at botox but at least mine has been in a shorter time span...i couldnt have coped for 4 years. This time i basically had to bully my CRS into doing LIS, thankfully it helped that this whole thing has made me malnourished.
Whats really annoying is 20 years ago LIS would have been offered to everyone after 12 weeks as that was the best treatment. Sometimes new ideas are great but LIS actually works 99% of the time.
Like you i cannot imagine not being able to put my cream up there and am dreading the first few days after the op.