by msimon » 31 Mar 2015, 16:10
This is great news FF! Finally you can work on a resolution to your problems. If you want my opinion, I would go with the least work necessary. As you probably know, many on here have not had success with botox long-term so I would think that given all the success stories, LIS would be the best choice for a chronic fissure. This is hard for me to recommend given my experience but I can't use myself as an example as I have complex issues down there.
Do you feel that you have spasms? Has your Doctor ever evaluated your tone down there? How much do you trust this Doctor? Are they a CRS? Can you take the time off to recover from surgery? Has this Doctor done many LIS surgeries?
As for the skin tag and hemmies, the more you remove, the more risk of complications such as infection, stenosis and longer recovery time. The hemmies may well calm down after LIS as the spasm will no longer prevent them from healing. I had my sentinel tag removed and that is the standard protocol of surgeons here as they consider them scar tissue and will impair healing of the fissure. I did not have anything done to my fissure (it did not have scar tissue). I would be reluctant to recommend having just a fissurectomy or hemmie work done without something that will ameliorate the sphincter spasms that will follow, such as LIS or botox. LIS gives immediate results, whereas botox will take 2-4 weeks for relief that may or may not come. Botox is less invasive, temporary and has a shorted recovery time.
It's a lot to think about. There is a lot of information on here as I am sure you know. It was a very difficult decision for me to make too and I tried the botox first. I actually think the results from that were better for me as I think it spread to my spastic external sphincter too.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain