Clinical, Manometric,and Ultrasonographic Results of Pneumatic Balloon Dilatation vs. Lateral Internal Sphincterotomy for Chronic Anal Fissure: A Prospective, Randomized, Controlled Trial
http://www.colonproctologia.eu/Pubblicazioni_Scientifiche_files/PBD%20vs%20LIS%20in%20DCR.pdf

Thanks Savaici.. I guess they are testing other methods to help us "AF" boardies worldwide.. Thanks sweetie

That's a good article, savaici.
It's too bad that our U.S. crs aren't all trained in BOTH methods. When I mentioned the AD to my crs, he waved his hand and rather dismissed the whole notion, saying that "no one here does that procedure."
Anyhow - I'm seeing a 3rd crs on Thursday. Golly sakes, I hope he's a good doc and can help me.

savaici wrote:Clinical, Manometric,and Ultrasonographic Results of Pneumatic Balloon Dilatation vs. Lateral Internal Sphincterotomy for Chronic Anal Fissure: A Prospective, Randomized, Controlled Trial
http://www.colonproctologia.eu/Pubblicazioni_Scientifiche_files/PBD%20vs%20LIS%20in%20DCR.pdf

great link
was myself considering dilation...over LIS. this gives my belief quite a lot of weightage. frankly gettng th e sphincter cut through seemed quite scary.
but one question 40mm- 60mm dilation seems quite a lot. is it actually so much?

rubius...
60mm seems pretty high to me, and would be way outside my comfort zone for concern over sphincter damage. Anatomy varies by individual, with women tending to be smaller than men anyway. 40 mm would still be large, but way more reasonable considering that the maximum aperture for the human anal canal is generally somewhere around 35 mm.

My surgeon has different opinion about ballon dilation. Explaning why she doesn't practice it, she said that fast inflation of the ballon to the high numbers can cause uncontrollable tears in the sphyncter vs controllable cut during LIS.

You are bound to get differing opinions from surgeons, but the conclusions are promising. Not everyone can undergo surgery.
CONCLUSIONS
This trial demonstrates that both pneumatic balloon dilatation and lateral internal sphincterotomy grant a high level of efficacy in the treatment of chronic anal fissure. Although there are few side effects after both procedures, pneumatic balloon dilatation reduces the du-ration and severity of postoperative pain. It is worth noting that there is a statistically significant reduction in postoperative anal continence impairment compared with lateral internal sphincterotomy. In addition, pneumatic balloon dilatation is a nonsurgeon-dependent procedure, and is easier to learn and perform. Thus, pneumatic balloon dilatation should be, in our opinion, the preferred procedure for patients with chronic anal fissure who do not respond to conservative treatment.
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