Hey guys, just got back from the doctor with an actual answer to what's up.
It's not a fissure, although they are quite surprised I'm not in pain.
It's pilonidal disease, with a nice wound about the side of the tip of my index finger. The surgeon actually went "hmmmm...let me go get my colleague". Horrifying sentence, that :)
So basically I need to get surgery to remove the area underneath it, rough up the wound a bit, and let it heal out from there. Not really what I was hoping for, but at least a definitive answer from a CRS.
They couldn't believe I wasn't in pain though. Apparently it's a larger than normal wound. Blech...Fridays are going downhill in quality nowadays!

Wow, that's a big wound. Sorry to hear about the pilonidal disease. I'm not quite sure what it is, but that sounds tough. Hopefully, the surgery will clear up the problem.

Thanks! Basically, they don't know for sure what causes it, but it's suspected that it might be hereditary and it also might be caused by little hairs getting caught in your skin and getting infected (I believe "pilonidal" actually means "nest of hairs" if memory serves.)
I'm a little interested in the surgery though; the surgeon told me they used to just excise the area and let it heal from the outside in, but that can be problematic due to bacteria, lack of oxygen in the area, etc. They use a newer technique where they actually make an incision to the side on one of your cheeks and go in from there. The wound that really needs the most attention is moved somewhere easier to clean, can get air, isn't prone to bacteria and so on. The surgeons both felt rather confident that a quick procedure, a couple of weeks of healing and I wouldn't have to deal with it again.
The nice thing is I'm 24, going on 25, and after about 30 the hair shafts thin and the cleft back there changes, making it far less likely I'll ever get it again. So this will likely be the one and only time I have to deal with it.
I know it's not a fissure, but I think I may still pop on the boards and let people know how it's going. Aside from pain in the bathroom this presents itself exactly like a fissure, so it's easy to confuse, plus it's just kind of nice to have a community of people to talk to openly about this sort of stuff. Friends and family listen and try to understand, but it's different to talk to people who are actively experiencing (or have experienced) it.

Yes, please so stay. It is good to chat. Plus, you will have valuable information that not many others on this site have and some of the same things might work for both conditions.

yes definitely keep us updated. i'm especially curious in hearing about your situation...since i've had 2 LIS surgeries already and still have "fissure" problems. i've always kind of wondered if maybe there was something else going on, but as long as i can tolerate the discomfort, i haven't pursued it.

Well, what I can tell you is that it's just like a fissure, basically a little tear in the skin (at least in my case...it can present differently), but it never hurt to go to the bathroom. It would bleed like a fissure for a minute or two, then stop, occasionally drain, etc. All those things like a fissure, but not one. Obviously LIS wouldn't help because it's not a muscle spasm thing...it could be a genetic issue, a trauma issue, a hygiene issue...the list goes on because no one knows for sure. They do find piles of hair in 50-70% of surgeries though. If they find a big pile in me I'll tell them to save it and I'll turn it into a little "pilonidal sock money" I can abuse at my leisure :)
It's generally not near your anal muscles, it's further up towards your lower back, though it's most often still in the anal cleft. In some cases, they may not treat it clinically at all unless it's infected or you're having some problem. It generally goes away towards age 30 - 40 and recurrence is low by that point, if at all. The wounds themselves will likely not close and surgery is really the only treatment available.
Depending on how bad the underlying conditions are, surgery can be a big deal involving a multi-day hospital stay and considerable care afterwards, but you can always find horror stories of worst-case scenarios. In my case, considering I have no pain (which very much surprised those surgeons) it's expected treatment will be simple and healing won't be a big deal. I'm looking to have it in June, back on my feet in a normal capacity by August. The prospect of taking care of this open wound (which will be made somewhat larger during the surgery to get the garbage out) scares me a little though. But what can you do other than work through it and get better?
If it gets bad, I've always got the forum to come talk to about it.

I bet it is a relief to have a answer to your problem....
I hadnt heard of it before but did a little google to inform myself !
I wish you well for the surgery in June...

well dealing, they have surgery options for pilonidial cysts. my friend's boyfriend has one and for him, it is a a pain in the ass but it's not in/on his ass, just above it.
i think if you make sure you get a surgeon that does this all the time and has a high success rate with treatment, then your success should be close, if not, 100%.
good luck and don't worry about the surgery since it is likely the pino cyst will not go away on its own. it actually i believe gets worse as time goes by.

I am sorry to hear about your diagnosis , it is serious condition and requires surgery and long term care but is necessary . I read once that if not treated in some cases it can develop malignant changes (god forbid) , so it is good that you went to the doctor !!! I am sure they will take good care of you and on the bright side you are very lucky that you are not in excruciating pain. Not long ago when I did fissure related research I stumbled upon one surgeon "blog" and he described your condition as very VERY painful .
Hope all will be well soon :D !!!! Keep us posted

Wow-an colorectal condition I haven't heard of! I am so sorry about the diagnosis but thank God that you are not in pain and misery. Best of luck to you!