...botox + fissurectomy, not sure I've seen this one around here before
I saw the CRS today and even though I said I wanted the LIS, he told me they only do it VERY rarely, when all else fails. This is because although when they do it it has very good success rates (89-98%), there's also a pretty good chance I'll need diapers when I'm 70.
So what he recommended instead is this: we should try botox first. However, since the fissure is chronic, he said botox is a 50-50 shot and they do it alone only for acute fissures. BUT, if they would refresh the wound and take away the dead tissue, meaning kind of a fissurectomy, then the chances go up to about 75-80%. The fissurectomy would be done using laser, which is supposedly the latest thing, and would mean scraping the old tissue away or burning it, so new and healthy tissue can grow back. It's done under general though short anesthetic, so I'll be sleeping through it and it requires an overnight stay in the hospital so they can help me with any immediate pain. Then it's a week away from work and another follow-up appointment in 6 weeks. The only possible complication, he said, is pain, the chances of anything else should be minimal. He told me they have had very good results with this procedure.
Haven't got it scheduled yet, they have some paperwork to do, but I've given my signed consent so it's on. I'll let you all know how it goes