Just a brief background. I've been dealing with a superficial fissure on and off for about 7 years. CRS I've been seeing told me it is superficial not deep but just enough to cause some pain and occasional bleeding. Since it is not deep, he did mentioned LIS years back as the last resort but said if you can deal with conservative treatments than do that. I've tried all the creams (Diltiazem, Nitro, Nifedipine) and even Botox. These creams do help but after a month or so, the fissure flares up like it has a mind of it's own. I could be fine for weeks or months and one bowel episode can unexpectedly change everything and I'm back to the self heal regimen for the next week or so. My flares usually last a few days and the cream and regimen usually heals it. My worst spasms lasted about 3-4 hours after a bowel movement.
My fissure was dormant for months until last June when it came back with vengeance. This was the worst in all the 7 years lasted for 2 months. Did Botox last August, fissure went away and in December as the Botox wore off, I had a slight relapse but the cream eased it a bit. At this point, I've really had enough and it's just annoying more than anything. Just thinking about if and when it will come back or going on a strict diet. My wife, family and friends don't have fissure and I see them eat whatever they want and don't rely on any laxative whatsoever. I want to live freely just like they do and not have to worry about what I eat and plan my day around that or a bowel movement. I truly believe it's not what I eat but the mere fact that I have a slightly "Tight Bum" that causes this nightmare.
I'm scheduled for a follow up with my CRS on 1/19 next week and will most likely schedule for LIS. He was on vacation last two weeks. Here's my two questions:
1) CRS said best to perform LIS with the fissure so that he can use that as a gauge to how much muscle to cut; usually the LIS cut is same size as the fissure cut. But if mine is now healed with a minor scar, can the LIS still be accurate in cutting the right amount? I have a superficial fissure that comes and goes. Even if the fissure opened up today, by surgery day, it may have healed.
2) I'm afraid of the pain post LIS. Since I have a superficial fissure, I'm sure the post LIS pain will be much greater. I've read in this forum numerous accounts of post LIS stories. Like any surgery everyone is different. But at this point, I'm just so annoyed with this fissure and want it out of my life and I'll willing to take the risk of surgery. I know, I'm such a chicken. After seeing what my wife went through with our first child makes me more of a chicken. I have to applaud all the ladies here who have gone through childbirth. This is actually giving me the courage to have LIS done.
3) Most people opt for LIS because of the massive pain/spasms due to their large fissure(s). As a result, LIS post pain was not as great compared to the fissure pain and LIS actually relieved pressure from the fissure. However with my case with a superficial fissure, I'm more annoyed than in massive pain so choosing LIS. Anyone here did LIS for a superficial fissure and your recovery/success?
Appreciate the feedback. Thanks all.

hello.. i'm so sorry that u r suffering. If pain has been annoying u and disrupting ur life, and u've tried everything u cld to try heal conservatively, then maybe LIS is the last resort to bring u to the "other side".
So many of boarders here came in with pain and tears and walk out of this forum with LIS. Read up more on this forum, read the bad and the good stories, prepare ur mind on the cons and pros.
Yes, i'm like u, i chicken out of LIS with my doc for multiple times. My CRS talked to me on the phone, trying to answer all my concerns, and eventually decided to walk with me on my path of conservative treatments. Along the way, i met with retears and the pain of internal piles, and now i'm much much better with minimal pain occasionally frm my piles and dry irritated skin on the edge of my anus (yes, i'm clueless y it occurs). So i'm an advocate of natural healing, but u know all these are depending on the many factors. My crs told me i'm one of those rare cases...
U may want to read up on this thread for some info "my success story"

Hi and welcome. I didn't have a superficial fissure, but instead very deep and to the muscle. I having pain the day of my LIS, but not bad pain. LIS was a breeze compared to my worst day with a fissure and spasms. Actually, that is the reason I had it. My spasms were more painful than my fissure and I would have them for hours all day. LIS is a breeze!!! Totally, not what I expected. I was sore, very swollen and bruised. The first 3 days are the worst. I can tell you I was given a Rx for Percocet on the day of my surgery, got it filled but never took one. I just took Ibuprofen the first few days and then nothing. It was the best thing I did and would do it again in a heartbeat!!! I forgot what it was like to not have any pain...and now that I don't have any life is sweet. I hope you feel better soon, and if you are at your wits end, have the surgery!! You'll be wondering why you put it off for so long

Thanks for your replies. I am scheduled for surgery on 2/6. Thinking about it makes me very nervous but I'm just done with this thing and need to move on with life. CRS said since I only have a chronic superficial fissure he will perform a closed LIS as opposed to open. I read online that closed method causes less bleeding but results should be the same. Anyone know if this is the case?