I have had a fissure for 6 years, and was treated with nitro cream in the beginning, and thought it was healed. After several months, the pain came back, and I have dealt with it now off and on for 6 years. I was able to manage the pain up until last week, when it got so bad, I had to take pain pills 24/7. Went to the CRS last Monday, and he said it was chronic and had formed scar tissue, and I needed surgery which was scheduled for the next day because I was in so much pain. He said he would not do the LIS on me because I was a woman, and he doesn't like to do those because incontinence in women is a much higher risk than in men. The surgery went great, he removed the fissure, scar tissue, tags, and a hemorrhoid I didn't know I had. I had a spinal, and heavy valium, and I didn't feel a thing. He also said he put some numbing medication in there, that would last for hours. I felt great that night, and wondered why I hadn't had the surgery years before, but the next morning, I thought I had died and gone to HELL!!. The pain pills did not even touch the pain.
Then, night before last, I had a major set back. I was feeling pretty good that day, the best I had felt all week. I took all my meds and went to bed. I was sleeping soundly, when I awoke with a pain that felt like I had been shot in the butt. I got up, walked to the kitchen, and by the time I got to the kitchen, the pain was so intense I was screaming. My husband was out on the deck smoking a cigar, heard me, and came in. He wanted to look at my butt, and when I took my pj bottoms down, blood was everywhere, running down my legs, and bright red. It looked like I was hemorrhaging, and I freaked. This was 11:00 at night, and my hubs called my doc. It took him an hour to call back, and by then the bleeding had subsided a little. The doc said to come in first thing in the morning, that he would be doing surgery, but as soon as he was done he would see me. Went in yesterday morning, and he said it looked like it was trying to form an abscess, so back to the operating room I went, and he loosed the stitches, so it could drain better, and he also lanced something or another....don't remember what he said now.
This morning's BM was horrible, I feel like I have had a complete set back. Anyone who has had this surgery, please, can you tell me when I should expect to feel less pain?? I am now a week and a day post surgery and I am still in MIS-E-RY!! PLEASE, can anyone tell me how long recovery will be, and when will I be pain free? Had I known this, I would not have had this surgery!!
Sorry this is so long, and rambling....I blame it on the drugs.

Aww heck, that sounds awful.
Are you taking stool softeners? That's most important, so that you don't hurt yourself even more. Take warm sitz baths, that will help with the pain, and relax things for you. And take some good painkillers! Anything, just get the pain under control, but take the softeners to counteract their constipating effect.
I don't know why your surgeon said he couldn't do LIS on a woman - that makes me wonder if he is a competent surgeon. I'm 44 with 2 kids, and had no problems with continence after LIS. It seems to be a cop-out with surgeons who aren't capable of doing LIS right!
There was another boardie who had a fissurectomy with intense bleeding - Dexterdude. His surgeon said it was normal I think.

I am taking valium every 8 hours, to keep everything relaxed, pain pills every 6 hours, with 3 Advil in between. An antibiotic, with a new one added yesterday, 2 dulcolax, 3 stool softeners, and 6 caps of metamucil a day. I am taking 3 sitz baths, and one after ever BM.
MY CRS is with the best group in my city, and came highly recommned, but who knows. I know I had so much scar tissue, that my anus was VERY narrow. A lot of this is my fault for waiting so long to have this surgery done. Perhaps had I had it done 6 years ago, a LIS was all that would have been needed. I asked him specifically about the LIS, and made it very clear that I only wanted to go through this once, and he felt the fissurectomy was the best route to go. Maybe I am expecting too much too soon. I just want my life back....a pain free life, without my every waking moment being consumed with BM's.

Aww, Lily's Mom, I'm so sorry you are suffering so much! Please don't blame yourself. Nobody deserve this kind of pain, and you were very brave to endure for 6 years!
I'm with Val about being somewhat puzzled by your surgeon's reluctance to do an LIS. Many, many moms here have had an LIS with no continence problems. Some doctors don't like to do an LIS on a woman who has delivered vaginally because women's sphincter muscle is smaller than men's, and there is often some trauma and damage to the anterior sphincter muscle during delivery. But a well-trained CRS would know how to perform the surgery in a way that is appropriate to that situation. I'm not a doctor, of course, but I would think that by performing a manometry to measure the anal resting tone (basically how tight the butt is when it's at rest), would give a surgeon a good idea of the level of risk of incontinence in such cases. This is just my opinion, but I would ask another surgeon in the group you are with, especially if you are having spasms and a lot of pain.
A fissuretomy is pretty traumatic. Other boardies here who have had that have also bled quite a bit and they do tend to take a bit longer to heal. It's unavoidable when there is a lot of scar tissue, though, so it looks like you got the proper procedure done. But it is a rougher recovery, I'm sorry to say, than just an LIS. The big issue right now is definitely pain management. Are you taking strong enough pain meds? I'm also wondering if 6 caps of Metamucil is maybe a bit too much. Metamucil adds bulk to stool, so maybe that's causing some of the pain. Have you tried Miralax/Restoralax/Movicol? (The name depends on where you live). Many of us here find that wonderful stool softener, although it can take a few days to start working.
I'm sorry I can't give you an idea of how long the pain will last because I had a different procedure (an LIS in May), so I have no experience to go by. I would say that if the pain isn't diminishing by the second week post-surgery, I'd go back and demand that something else be done - botox an LIS, or something.
I really feel for you! Everyone here understands the pain you are in and how debilitating a fissure is. You will get lots of support and advice from the great people here.

Hi Lily,
I'm so sorry to hear what you are going through!!
I agree with Hope and Val. I am also very puzzled about your CRS not giving you LIS or Botox along with your Fissurectomy. I don't think that I've ever read of anyone on here getting a Fissurectomy without LIS or Botox...I don't understand how the fissurectomy is suppose to heal without the sphincter being looser?!

I also agree with Hope 100% about giving this 2 weeks post-op and demand demanding LIS or Botox.
I had four kids and had LIS and I'm not incontinent either. I'm with Val, it makes me wonder if your surgeon is competent.
Gosh I hope things get better soon! How awful!

Thank you all for your kind words. I am taking oxycodene, Surfax stool softener, which has always worked best for me, and metamucil, because that is what was on my post op instructions. After the last procedure on Wednesday, I asked him if I could take benefiber, because that was what I have always used, and he said that was fine.
I was just talking to my husband about the LIS surgery and why my CRS opted not to do it, and he said that the doc said he would evaluate the situation during surgery, and if he thought I needed it, he would do it. I honestly don't remember him saying that, but I was in so much pain that day, that I'm not surprised. After the surgery, when he told us all he had done, I remember him saying that I did have a very tight anus, but that was not a bad thing, whatever that means . I was so out of it, I didn't ask him anything further on that. I asked him if I was going to be able to have normal bowel movements again like normal people, and he assured me I would. He said pain wise, the first two weeks would be the worst, and I laugh as I say this, he also said I could return to work in a week, which would have been yesterday There would have been NO WAY!!
I did feel somewhat better today after the nightmare of my morning BM. I just wonder when you ever stop having pain after having a BM. For those of you who had the LIS, how long for your recovery, and no pain? I am really not a baby, but his is the worst pain I have ever felt, including kidney stones!! They were a breeze compared to this.

You are definitely NOT being a baby! There is nothing in the world like fissure pain. I had gallstones, which feel like you're grinding broken glass in your guts, and a hysterectomy, which was very painful because the morphine didn't work when I woke up from surgery! Neither of those were anything like fissure pain. There was a boardie here who had been shot and said that the gunshot wound wasn't as painful as his fissure!
My pain diminished significantly after the first three days post-op. I still had pain, but it was a different kind - not the burning, passing shards of glass, screaming with every poop, weeping for hours afterward kind of pain. It was more like a dull, aching pain. It gradually improved over two weeks. By week three I was feeling mostly human again. Surgeons almost always underestimate recovery time. That is SO common. Two weeks at least before considering going back to work. We should really write a set of guidelines for surgeons! :roll:
I'm still puzzled by your surgeon. Now, I only have a medical degree from the University of Google, so please take what I say with the appropriate grain of salt :) but I'm confused about the claim that there's no problem with a sphincter that is very tight. My understanding is that a chronic fissure will not heal because the sphincter is too tight and spasms, and that prevents blood flow, which in turn prevents healing. The purpose of an LIS (and botox) is to loosen the sphincter so that blood will flow properly to the area and promote healing. The LIS doesn't heal the fissure directly; rather it creates the conditions for the fissure to heal. I've done a lot of research on this (I was terrified of having my bum cut!), and I'm quite confident that this is the case. So, I would ask the surgeon how the fissure will be able to heal if the sphincter is tight. I still think you should get a second opinion. Your CRS is probably very good, but it certainly couldn't hurt to get another opinion from a good CRS, especially if there is no improvement in the pain levels over the next week.
Are you taking warm/hot baths? Those can really help with the pain - they also promote blood flow and so also healing. I really hope you find relief very soon!

I think a second opinion may be needed.
A tight anus is a bad thing when you need to heal a fissure. That's the whole reason LIS/Botox is needed.I can't understand a CRS saying this when healing a fissure is all about a looser anus. That is just crazy in my opinion! :roll:
I had LIS, skin tag removed and fissure cauterized and never had a painful bm since my surgery. I was sore for a couple of weeks,like bruised. With that being said, I had a really good recovery! It's not uncommon to have post op pain though! Many folks have had pretty rough couple of weeks especially with fissurectomies.
I don't recall anyone on here having a fissurectomy alone though and that's what really concerns me..
I hope your CRS is right and all heals well and I learn something new again! As Hope said it surely wouldn't hurt to get a second opinion if you don't get some improvements within the next week.
Take care.

Basically all he has done is create you a bigger fissure - albeit one without scar tissue! He hasn't done anything else to actually try to heal it - no wonder you are in agony.
Yes, definitely get a second opinion - preferably with a CRS who has a lot of experience of LIS ops!

Well, another day of a drug induced fog. After morning BM, took 2 pain pills and the valium, and slept most of the day. Woke up around 5:00 felling pretty good, with little pain. Then about an hour ago, I had to have a BM. "Please God", I said, "let it pass", but of course it didn't, and I had to go. The BM itself was not bad, but as soon as I got out of the tub, the all too familiar pain returned. Took 2 more pain pills, and it is subsiding now, somewhat. I see no difference in the pain after a BM now, than I did before this surgery. The pain afterwards is just as intense, if not more so. I can't tell if the pain lasts as long, because of the pain meds. When I woke up at 5:00 this afternoon, I was not in pain, so it may not be lasting as long. At this point, I can't see every having a BM without a pain pill. I am completely depressed, and feel like I had the surgery for nothing, after waiting so long to have it. Granted, I probably needed the fissurectomy, because I had so much scar tissue, but I should be getting better not worse. I can't believe I am probably going to have to have surgery done again. I am so depressed, all I want to do is cry. If I saw just a shred of improvement, I would say, "well, maybe, I am getting better". I feel like I have been butchered!