Recommended LIS surgeons in London (esp for females)?

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Re: Recommended LIS surgeons in London (esp for females)?

Postby owmybum » 16 Feb 2019, 13:23

You can just read my diary in the ‘diaries’ section. It’s entitled owmybums flap diary.

I had low resting pressure, so I was not in the frame for LIS.... although one young nhs consultant said I would be ok having a partial one... I didn’t want to go down that road if pressure wasn’t the problem.

The laser surgery sounds interesting.... where do they do such surgery?

I have actually been through a lot of emotional stress in the last couple of weeks.... but I also know my set back was the result of a greedy amount of 3 bean stew and quorn... and not nearly enough water!
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Re: Recommended LIS surgeons in London (esp for females)?

Postby Bkan » 17 Feb 2019, 10:21

Hi I have read your diary thank you, it was an interesting read.

The laser LIS are done in Europe and I also found southern India carry out this procedure, but it's only worth doing if your resting pressure is high. The following is an interesting read

https://www.omicsonline.org/proceedings ... 93115.html

Let me know if you need further input on this as I have been researching on this in the past few weeks
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Re: Recommended LIS surgeons in London (esp for females)?

Postby Bkan » 17 Feb 2019, 10:30

This isn't also a good read with interesting points about function of sphincter and pressure following a LIS

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1357726/
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Re: Recommended LIS surgeons in London (esp for females)?

Postby owmybum » 17 Feb 2019, 14:30

Thanks for the links. Very interesting reading.
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Pelvic floor therapy
Diltiazem
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EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: Recommended LIS surgeons in London (esp for females)?

Postby Bkan » 17 Feb 2019, 16:32

Just a quick question if you don't mind me asking. You mentioned above that your internal sphincter pressure was not high. Did you have a physiology test to tell you what your resting pressure was?

I have had 2 of these tests at 2 different hospitals and readings were 108 mmhg and 113 mmhg...these were the maximum resting pressure reading. So according to the articles these fall in the range that LIS was carried out for the studies and the second link talks about how the resting pressure goes back up eventually within 12 months but not to the point it was pre op.
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Re: Recommended LIS surgeons in London (esp for females)?

Postby owmybum » 20 Feb 2019, 05:15

I’m sorry, I haven’t got the readings.... it was done a few years ago, and I cannot remember what they were, only that they were normal to low. If I have a dig around I might find some paperwork.......

Can I ask why you had 2 tests done?
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
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Re: Recommended LIS surgeons in London (esp for females)?

Postby owmybum » 20 Feb 2019, 06:01

I did some digging..
Anal resting pressure 116
Voluntary contraction 76

Normal resting range is considered 60-160
Normal contractions 50-180

Hope that helps x
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
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Re: Recommended LIS surgeons in London (esp for females)?

Postby Bkan » 25 Feb 2019, 06:44

Hi owmybum

Sorry for the late response.

I had 2 tests at 2 different hospitals (both NHS). After having my first one, the consultant wasn't that keen on me having the LIS as my pressure was high, but he mentioned that my internal sphincter muscle is thin and isn't doing much now anyway. So I decided to go private and the private consultant I saw advised me to go under his care at another's NHS hospital and he was not convinced with my physiology test from the first hospital as there was no measurements of the internal sphincter muscle so he asked for me to do another test under his care.

First hospital worked on different metrics I noticed when comparing the 2 results.
They worked on mmHg, my result was:
Resting (max) 113.3 mmHg
Squeeze tests (voluntary contraction) 45.2 mmHg

Normal readings in mmHg are:
Average anal resting pressure 31-100mmHg
Max anal squeeze pressure (Bol contraction) 43-313mmHg

Second hospital looks like they used the same metrics as yours (you mentioned above), my result was:
Resting (max) 148 cm H2O (previous forum I sent you I converted them into mmHg -108mmHg)
Squeeze test (voluntary contraction) 42 cmH2O

Normal ranges in cm H2O are as you mentioned above
Max resting pressure normal range 60-160cm H2O
Squeeze test (vol contraction) normal range 50-180 cm H2O

I am not convinced with the above figures and I will be bringing this to my next appointment as stated below:

1) Normal resting pressure figures are neither here or there, e.g. 60-160cm H2O. Is having a resting pressure of 60 ok where it does not leave you incontience, e.g. If we had a partial LIS Surley that would not drop that much, e.g. Below 60 where it would leave us incontience? I would be asking my colorectal surgeon this on my next appointment.

2) the normal range figures between NHS hospitals are inconsistent, e.g. When converting the first hospital mm Hg normally resting pressure figure to second hospital cm H2O I get the following:

31-100 mmHg when I converted it to Cm H2O I get 42cmH2O - 136cm H2O
42-136cm H2O does not tally to the normal range the second hospital gave which was 60 - 160 cm H2O
I will be questioning this also on my next appointment with my colorectal surgeon.

The above does not give me much confidence, as different NHS hospitals are using different normal ranges. Colorectal surgeons maybe making the wrong decisions and this is worrying.
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