A few of you many have reed my posts where my fissure was at a 10 where I could not work, sleep or walk. My CRS started my on diz cream, diet and sitz baths. Things were going outstanding, where I went from a 10 most days to a 5 and then pretty much pain free. However with that said, I had a bad BM and while it did not bring me back to a 10, I was at a 7. So I said hell with this, I want my life back and I went to see my CRS and planned on a LIS in January
I read about a new Anal dilatation (sphincter stretch) is another way to treat anal fissure. An older method of anal dilatation was commonly used until LIS was introduced in 1969. In this older method the surgeon inserted his fingers into the anus and spread the anal opening "manually." This was relatively uncontrolled, and often resulted in some degree of incontinence. In the 1970's LIS became the standard operation for anal fissure because it produced lower rates of incontinence than uncontrolled manual dilatation. In the 1990's Dr. Norman Sohn developed “Standardized Anal Dilatation.” This procedure stretches the sphincter muscle in a measured and controlled way that is significantly less likely to produce incontinence. This method also reduces the chances of other complications, such as bleeding and infection. Dr. Sohn treated more than 2000 fissures this way and claimed to have an 87% fissure healing rate (95% pain relief with or without full healing) and an incontinence rate of 0.3%.
I had a few response from others here that said why go this route when a LIS is the gold standard….Many other CRS may advise against anal dilation, because in the past it was shown that non-standardized had more incontinence then LIS. However this was the old process and many CRS have not been trained on this new technique. Also lets face facts, CRS are surgeons.
I found a CRS in my area that offers this. In fact where I live in the NY area, he was named one of one of the top 10 specialist by a leading NY magazine that is known for this rating they do every year. I had my appointment today and I had the opportunity of speaking with several patients that were there for follow up appointments. ALL were healed and had no pain after the first week or so. Also, all that I spoke to were back to work in less than two weeks. Two had this done on a Friday and was back at work the following Monday!
I met with the doctor who said after learning this new technique, has not performed an LIS in 6 years. He said why should he when the results are about as good as a LIS with no complications. There is no chance for infection simply because no cuts are made. I have an appointment to have this done in early January….
Please understand, I am by no means saying no one should look to have a LIS. What I am saying is that if you are told you need an LIS, perhaps you find a CRS that offers this in your area and spend some time discussing your options. For me, given what I read and the people I spoke with today in his waiting room, why would I want to have a CRS cut me if I can have the same results with this?