OK so i saw a surgeon finally after 5 months of dealing with this fissure. he had a look with his camera and said he can see scaring for what looks like a healed fissure, but will probably keep retearing (which it is!). he said i need surgery, and he made out like it was no big deal.
i said i was reluctant because of incontinence and he said there is 0 chance of incontenence! he said he has never had a patient with any level of incontinence, and he only cuts the muscle a tiny bit so u still have control.
i was still reluctant though and asked for botox, and he is asking a collegue to do this for me. im sorta feeling like ive made the wrong decision now though as he seemed so confident about LIS. he also said it will take 1 week to heal???
has any one ever had a surgeon that confident, and then ended up with a bit of intontinence?
he also works with my mum and so if he did leave me incontinent hed have to see her at work all the time...

YES, my surgeon was that confident. NO I'm not incontinent in the least...in fact I might consider doing the surgery again because I'm still having retears once in awhile 8 months later.
I don't think you'll find anyone on this board who complains of incontinence. There are those who experience very slight leakage after BM's but it's more of an annoyance, like you have to go wipe a bit again. But true incontinence? Absolutely not. I think it's virtually impossible if the surgeon has his eyes open when making the cut.
I was once afraid of incontinence too, but reading other's experiences on this board completely eased my fears. You can certainly try the botox, and I don't want to discourage you. However, it's more of a temporary fix and the muscle will tighten back up after it wears off. Surgery is a permanent fix. But you'll know when you've had enough, and you're ready to do the surgery.

ur CRS sounds like a very typical surgeon. It's quite true that incontinence is of a slim chance especially if the CRS has lots of experiences doing the LIS. I personally feel that if urs is a chronic fissure, botox might not be able to help u more than LIS. That being said, i don't mean you still can't heal naturally. Cos i did, even after 5 months. If you like, you may read more on my healing regime from the thread "my success story".
Take care and hang on!

I would consider the surgey since you have been miserable for a while. Like Alpine said, Botox is a band aid on a chronic problem and will only fix it temp. It sounds as though your CRS is very experienced. Those are the things you want to hear!!! 0 with incontinence and no big deal, sounds like he as done many!! and is no big deal to him, but us being on the other end it is a big deal!! That would however, put many fears aside for me. I am going for a consult 12/1/11 and I hope to hear those words from my CRS. I have been miserable for 3 years and am done!! I am having surgery. Good luck with which ever you choose :)

I had the LIS surgery 1 week ago. My CRS immediately said surgery and I said to my self...of course a surgeon is going to recommend surgery. I thought I had a hemmroid problem and he diagnoised a chronic anal fissure. I had issues for years, and more recently 7-8 weeks of pain, spasms, bms feeling like shattered glass coming out. I told the CRS....I would prefer healing over surgery...and he said it was my choice.....he gave me some cream and in week I called and said I want surgery asap. Had the surgery last Thurs and was back at work on Mon. Surgery was short and awoke with alittle discomfort, sore, tender but MUCH better than before the surgery. I was having spasms all morning of the surgery. I am having normal BMs (with the help of Stool softeners, prune juice, and miralax). I was done with letting the AF run my life.
I have no incontinence issues!!! However....I do seem to "toot" alittle more than I used too!
My surgeon seemed almost arrogant about it being no big deal...and didn't understand my hesitation. However....he was an experienced CRS and had seen patients like me before.
I have no regrets....and I have my life is good once again!
Good Luck! There are alot of posts on the forum and I haven't seen any regarding issues with incontinence.
The surgery, for me, was a breeze! I wish the same for those who opt for surgery!! Keep us posted.

after having a bad retear today i am fed up of it. i am going to write to my surgeon and tell him that i want the surgery. i just want to move on with my life now

Hey Andy, sorry to hear you are still suffering. It's good the surgeon is quite confident and if it's surgery you want then go for it. I am due to go for my botox on Monday so can let you know more after that. I have been alot better and only re-tore about 3 weeks ago and it healed again within 3 days to almost no pain. I just have niggles now. I can let you know more about the botox after Monday!! I've decided 2 rounds of botox then surgery if its not completely gone as I too am sick of not being able to fully do what I want (although life has certainly got alot easier now!). Not being able to comfortably drive is the thing for me! They are reluctant to do it for me as I am female and because of my age. Good luck with whatever you decide to do, will keep you updated on what happens with me :)

Sue, im glad to hear you are feeling better. What was the turning point for you? have you done anything different or has it just settled down?
i recently had 3 good weeks, and had a retear which healed in one day. i was starting to think it was healing and strengthening. but today its up there with my worst retears.
a few hours ago i was 100 percent opting for the surgery, but again doubts are creeping in! i really dont know whether to try botox first. my surgeon really wanted me to get the LIS. i look forward to hearing how your botox treatment goes, hopefully it will be enough to get you that final bit more healed.

btw what did you mean when you said because of your age? do they think you are too young or too old?

I don't know what the turning point was really, it was around the end of September, 6 months after I first got it! I use rectogesic twice a day, take some lactulose each morning and one docusate sodium tablet at night. I was also taking St Johns Wort (that was for something else), and still take garlic tablets and Evening primrose oil (which has vitamin E in). Using baby wipes, drinking lots of water and changed my diet, not doing sitz baths due to other issues. Thats been my routine for the last 6 months. I wonder if its because I'm moving about alot more in work that its improved. I too get 3-4 weeks where its improved, just niggly pain every now and then, then get a re-tear. Mine was in half term (I'm a TA), and it wiped out half my hols, was bad - boo! I really don't know what they'll do tomorrow as had a few good weeks but am pushing for the botox as I am getting spasms more than pain now. They don't like to do it because of my age and the fact I'm a woman as it can cause compications in childbirth so I don't think that would be a problem for you!! They said surgery is the last option and I do agree in some ways in my situation. It may be different for you. You could always try the botox and if it doesn't work then go for surgery. I'm sure that you would get some relief from botox even if it doesn't completely work for you. You won't know unless you try. I don't want to influence you either way as you need to make the right decision for your situation. Just given you my opinion, could you talk it through with someone? I talked it through with my Mum and she was good as she was impartial, letting me work through the positives and negatives. Will keep you updated on my situation and good luck with whatever you decide to do. Feel free to message me anytime :)