So I went to the surgeon in June and he basically said that it was time for the LIS. I signed the consent, and was told to wait to hear about a surgery date. Well, finally, yesterday the office called but I wasn't home. I have yet to call them back. I am just so torn (no pun intended!). I don't know what to do. Since May my pain and bleeding have really decreased. I have found something that works for me, a hot chai latte or a mocha on an empty stomach in the morning makes me go everytime, and it's soft and usually there is no trouble. I still have the burning and a little pain afterwards, but the pooping shards of glass sensation doesn't happen. I have probably only had 3-4 episodes of so much bleeding that the toilet water was red, otherwise there has been the odd streak on the stool itself or some on the toilet paper, sometimes none at all. I would like to get rid of the 3 external skin tags though, and the surgeon said he would clean the outside up. I asked him about incontinence and he told me that NONE of his patients have ever reported any lasting incontinence. There have been some reports of gas leakage immediately after surgery, but other than that, nothing. He actually told me that when he had time, he wanted to call all of his LIS patients to ask about any long term incontinence so that he could do some study or something. That was reassuring to hear, but I am still scared. After BM's now I have a bit of leakage anyways, so would it really be any worse? I'm trying to talk myself into this but it's hard. I have also been on Maternity leave for the past year, and was hoping to get the surgery over with before I went back to work so I could recover, but now it's time to go back and I'm not sure I can afford to take time off. How long did others who have had LIS take off work? I am a little concerned with the after pain too, as I think I would be getting a bit of work done (I'm pretty sure there is more than 1 fissure, and then the removal of the tags)! I've had internal hem. banding before and I didn't feel a thing, so maybe it wouldn't be so bad? I can handle pain, I've given birth twice with no drugs, but the acute pain of childbirth is different. It's intense, but it doesn't last long. I can't stand lingering, annoying pain. I think it would be worth it though, to fix this problem forever, if I knew I wouldn't be incontinent!
I also have a weird question, mainly for the women of the forum I guess, although the men may have experienced something similar. I can't seem to have sex on days that I have had a BM. One, for cleanliness reasons, I just don't feel fresh unless I have a bath right before, but it feel like my whole perineum gets swollen after a BM which makes penetration (sorry) painful. Has anyone else experienced that? By the next day the swelling goes away and all is well again. On days that I don't have a BM I don't even think about my butt, but on days that I do, there is always this dull ache/burning feeling. I just want it to go away but I am SCARED!!!! I don't know what to do. I've read many of your LIS reports and some have had no pain and some have had excruciating pain, but I haven't come across anyone with long term incontinence (even gas) I don't think, is that right?
Please help!

Hey scaredy_butt,
I haven't read of anyone with long term incontinence either.
I haven't had the surgery yet either and I am scared to death at this point.
I have an appointment in a couple of weeks to talk to my crs about it and I have been a mess. I am so afraid of the pain. I have read some horrible stories and wish I would have never researched other peoples experience but I also wanted to know what I may be facing and what to expect. Hopefully you and I will be one of the more encouraging ones and can come back and tell our stories!
How long have you had your fissure? Is it chronic yet? I have had mine 7 months now.

I had LIS surgery six weeks ago. I had mild incontinence for a few weeks after the surgery, which is to be expected, but now it is gone completely. I wore panty liners for the first few weeks after surgery, which worked well.
I have read many reports of LIS, both anecdotal and scientific. It seems that there is an issue with incontinence after LIS, but it is fairly rare and is largely a problem for those people who had incontinence prior to the surgery.
Here is an excerpt from a very good site on anal fissures found here: http://www.medicinenet.com/anal_fissure/article.htm
In a large series of patients followed for a mean of five years after surgery, 6% were incontinent of gas, 8% had minor soiling, and 1% experienced loss of stool.
That means one in a hundred patients actually had lasting fecal incontinence.

I think only you can decide whether or not to have the surgery. It is going to be painful - there is no doubt about that. But for most of us here, life was painful without the surgery. And, as my surgeon explained it to me, you can either have fissure pain that goes on forever, or you can have surgical pain that goes away in a few weeks. Put that way, the surgery sounds pretty good.
If your fissure is healing, or the discomfort you suffer from is fairly mild, then you might want to hold off and see if you can get better without the surgery. For me, my fissure was not getting better, and the pain and discomfort I was suffering from was having a major impact on my life. I felt I had no real option but to have the surgery.
Having had the surgery, I could not be happier. I am back to normal, with no pain or discomfort. BMs for me are what they were years ago - normal. So, for me, the surgery was both necessary and very successful. But every person is different, and I'm afraid you will have to make that choice for yourself.
If you decide to hold off for now, you can always have the surgery later. That is what many of us have done. Some people get better without the surgery; some don't.

I've had issues with BM's as long as I can remember. I wasn't very regular, and didn't really think much of it when I was younger, and about 11 or 12 years ago I had "the" BM. Blood in the toilet and red toilet water. I was freaked of course, but being 18 or 19 at the time, was too embarassed to say anything, so I let it go way too long. I finally got serious about this about 6 years ago, but was misdiagnosed and even given a sigmoidoscopy for which they do not put you to sleep. For those of you who have had a rectal exam with a fissure, you can imagine how much that scope hurt. Yet, even though I was writing around on the stretcher in tears, the Dr. didn't clue in that it could be more than a hem. Then I saw another Dr. who decided I needed a colonoscopy, which is fine, at least I was sedated, but still no fissure diagnosis. Finally, I was referred to this current Dr. who took one look and diagnosed me. I have seen him twice now, the first time he gave me Diltiazem, and this last time he recommended surgery. I will likely go through with it, I was feeling pretty good for a couple of months, and then all of a sudden was a bit constipated and it started all over again. I thought to myself, "alright, enough is enough." I'm tired of all the bleeding and pain. I just want to be normal again. I used to be a blood donor too, but haven't been able to recently due to the anemia (and pregnancies), I would like to get back to doing that. I think about how much blood I must be donating to the sewer, it might as well go to someone in need! I am type O- as well, so my blood is very much in demand as it can be given to everyone and it used often in emergency situations when there is no time to type and crossmatch the patient. It makes me feel good to know I am helping people in that way, and I miss donating. But I need to look after myself before I can worry about others. The pain doesn't scare me really, I'm certainly not looking forward to it, but I think it's a necessary evil. I'm concerned that I can't afford to take much time off work, and worried of course about the incontinence. Those are my two big issues. Plus I have 2 young kids that need to be taked care of, and if I can't lift them I will need someone to help me with them. I will keep you all posted on what I decide.
What was the prep like before surgery? Did you need a completely empty bowel like you do with a colonoscopy?

I agree, enough is enough... There's only so much you can do and if it's not working then it's time to move to the next thing. As much as I don't want to myself, I am going to have to have the surgery.
I am still not sure if they give you laxatives or what before the surgery. Everyone's doctors were different from what I have read. My doctor mentioned doing mine and a colonoscopy at the same time. I guess I will know after the next appointment.

Hey there, you don't need a *completely* empty colon like before a colonoscopy for LIS alone, since they don't need to visualize anything other than the rectum. For a colonoscopy they need to go into the rest of the colon which is why you have that full day of fun the day before. Surgeons do like having an empty bowel to work with, though, so in most cases you'll either use a Fleet enema or otherwise have an empty bowel before surgery. When I had LIS, I used a Fleet enema, but when I went in for my second surgery, I just told the surgeon that I already pooped a lot from my daily Miralax and she was okay with not using any additional laxatives.
Of course if you are having a colonosopy at the same time, then it would be a different story.
I had a proctoscopy during LIS so it's not unusual to do other diagnostic procedures at the same time since you're out from the anesthesia anyway. That way they can make sure there's no other problems like inflammatory bowel disease before cutting, since you probably wouldn't want to do the surgery if the root cause is inflammatory bowel disease rather than a sphincter spasm.

I had LIS and Fissurectomy 5 weeks ago and had temporary incontinence which lasted for about 2 weeks, it wasn't an every day occurrence but did last that long, I wore panty liners like phil, but didn't really feel that comfortable in them so didn't wear them all the time, at 5 weeks post-op there is no incontinence problem at all.

Phoned the Dr. today to book my appt. but ended up not booking it! LOL. The dates that were available were too soon because I am waiting to hear when my retraining for work will be after being off for a year on Maternity leave. After my visit in June, I was hoping to just get it and get it done, but I think they must have misplaced my file because I didn't get a call back until last week. So anyways, after explaining my dilema to the receptionist, she said I could call back when things are sorted out. I was still flip floping about doing it, because things have been pretty good lately. I had a regular BM this morning, then after lunch had a bit of diarrhea which caused some bleeding, so that did it for me. I just don't want to yo-you back and forth anymore. As much as I dread the surgery, and am scared about losing some bowel control, I am also tired of the pain and bleeding, and the "not knowing" if the next BM will be the one that starts everything all over again, or the one where I bleed to death! Ok, well that's a bit of exagerating but sometimes it feels like I might!

I had 2 LIS surgeries and I have no incontinence of any kind.
I just want to say that you HAVE to regulate your BMs more successfully since it would be optimal for your butt to have BM at least once a day :roll:
If you continue to have irregular BMs - it will be hard to heal your fissure even with LIS : (((
Regarding sex question - no, I never had any swelling happening after BM , but still , I was so much in pain that I was not in the mood for it at all : ((((.
Wishing you best of luck with healing