After 10+ years of on&off fissure pain, I think I can officially say I am 100% healed. For the longest time I neglected to see a CRS and NEVER considered surgery. As a male in his 20s, I couldn't talk to anyone about it. I had somehow convinced myself that this intense chronic pain was ok to live with. Days of unimaginable spasm pain that would last hours after a BM. Bowel movements that made me almost cry, bite down on towels, and almost pass out from the intense pain. Looking back on a decade of pain is honestly embarrassing.
Let me tell you what my CRS said... If your fissure has lasted more than 6months (tearing/healing/tearing), a LIS surgery is your only hope. The sphincter spasms clearly won't relax long enough for the fissure to heal correctly. Creams like nifedipne may help some, as it gave me temporary relief but in the end your fissure will re-tear. He told me botox is a joke, VERY high failure rate and too expensive. After the facts were laid out for me, I schedule LIS surgery....
Surgery day was simple enough. AM operation that lasted 30 or so minutes. Woke up with some pain, and then more pain later in the day. I fasted the day leading up to the operation and the day of; trying to avoid a BM for as long as possible. I experienced small amounts of leakage from the incision site up until week 5 or so and wore small pads on my underwear. I took only 10 days off of work after surgery.
Listen, if you're on this site then you've probably have some sort of anal pain. I understand everyone is different and some may heal quicker than others. However, this was the best decision of my life and I hope you come to a realization that surgery may be your only way out of this hell. Call a CRS, talk to them, and take their advise. LIS is a tried and proven operation and the success rates are extremely high. Hope this helps someone out there, as I relied heavily on the forums the past couple years.
Best