LIS is only temporary fix?

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LIS is only temporary fix?

Postby Guest » 28 Jan 2013, 12:55

Has anyone else been told this? I saw my surgeon today, and was scheduled for surgery in 4 weeks. He said the surgery in not a permanent fix for this problem, because the cut they make in the sphinctor closes back together with scar tissue. He said he also only does botox if the LIS surgery doesn't work. Has anyone else been told this? I am nervous, but also looking forward to surgery at the same time. I just want to be normal again.
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Re: LIS is only temporary fix?

Postby thisfissurecankissmybutt » 28 Jan 2013, 15:53

Are you going to a board-certified colorectal surgeon (CRS)?
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Re: LIS is only temporary fix?

Postby jr2 » 28 Jan 2013, 19:41

LIS is an effective procedure for helping a chronic, non-healing fissure to heal. The tone of the sphincter is greatly reduced at the time of surgery, and research shows the tone begins to increase again over time, though never back to the same tone it had before surgery. Yes, there will be scarring, as there is with any surgery, which will make the area less elastic.
So, to answer your question, I have heard something similar from a top-rated, board-certified surgeon. However, the reduced overall tone in the muscle should reduce chances of recurrence in the future, and should also make any future recurrences easier to heal. But not always.
Lastly, fissures are complicated. No treatment is an absolute guarantee. People have failed LIS experiences approximately 5% of the time for a chronic fissure, depending on a lot of factors, including the skill level of the surgeon (I posted in the references section in a post called, When LS fails). You want a highly experienced surgeon, board-certified, and you want to ask specific questions about his success rates and complication rates.
Last edited by jr2 on 28 Jan 2013, 19:46, edited 1 time in total.
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Re: LIS is only temporary fix?

Postby jr2 » 28 Jan 2013, 19:44

And if you have any unanswered questions or doubts, listen to your intuition and get another opinion. All of your questions should be answered and you should feel very confident going into your surgery.
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Re: LIS is only temporary fix?

Postby Davo » 03 Feb 2013, 15:44

Hi,
LIS is not a temporary fix - it weakens the sphincter which allows the fissure to heal before returning to about 80% of it's initial strength.
Below is a reputable report which I was reading which compared anal resting pressures in 50 patients (23 female, 27 male) following LIS.
The resting pressure was read before LIS surgery, straight after and then at 3, 6 and 12 months.
Resting Pressure 1 month before surgery = 138
Resting Pressure 1 month after surgery = 86
Resting Pressure at 3 months = 95.4
Resting Pressure at 6 months = 102
Resting Pressure at 12 months = 110
What this demonstrates to me is why patients may suffer some mild temporary incontinence immediately following surgery and why CRS’s suggest that full healing occurs in 12 months. It shows that the sphincter is at its weakest immediately following surgery and a constant healing improvement continues over the course of 12 months post surgery.
Hope this is some help
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Re: LIS is only temporary fix?

Postby jr2 » 03 Feb 2013, 17:35

Just to point out that the resting pressure does increase over time as per the statistics Davo shares. The pressure doesn't return to its original state, but as it does increase significantly, it is still a good idea to remain careful with one's diet, etc., permanently, to prevent constipation and straining, as LIS doesn't guarantee a person won't ever get another fissure years down the line.
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Re: LIS is only temporary fix?

Postby Davo » 04 Feb 2013, 15:22

Hi jr2,
In my case a return to 80% of it's original state is perfect as i was too tight in the first place and this is one of the things that probably contributed to my fissure in the first place.
Completely agree about maintaining a healthy diet however there is no need to be anywhere near as strict as I was during my fissure days.
My doctor always said to me, "If you maintain a healthy diet now with lots of fibre i promise you your health will be considerably better in twenty years time from now"... I guess that kind of stuck with me
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Re: LIS is only temporary fix?

Postby Turk the cat » 04 Nov 2013, 16:06

Couple of questions:

Does having LIS on a fissure then contribute to the relaxation of the "entire" anus? Meaning less chance of a new fissure developing elsewhere?

My CRS has given me the impression he's going to do LIS on a fissure he says has healed. Does this sound wacky? I have since developed a new fissure.

Fwiw, the CRS would be doing skin tag removal at the same time as LIS.
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Re: LIS is only temporary fix?

Postby east_1234 » 05 Nov 2013, 04:04

Hi Turk the cat, from what I understand about what LIS is, I think the LIS can be performed anywhere of the internal sphincter muscle ring to reduce the pressure of the entire opening (i.e. the cut can be made anywhere in the sphincter muscle ring). Only one cut will be made. So it is not targeted on specific fissure, although I guess they might consider the site of LIS excision based on where the fissure is.
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