When is a fissurectomy needed instead of just LIS?

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: When is a fissurectomy needed instead of just LIS?

Postby resume » 17 Jul 2013, 07:11

I'm so sorry you're having such a difficult time hopeful. If you do end up having LIS don't worry. I wish I had known how simple the procedure was. I spent weeks stressing about it! You will get past this. I know it's miserable right now but there is light at the end of the tunnel! Don't give up hope! :)
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Re: When is a fissurectomy needed instead of just LIS?

Postby GeorgeTheCatMan » 17 Jul 2013, 16:03

Hello Luka, I asked the CRS that same question last visit. He said that he almost always does LIS and a fissurectomy together. I believe that he said that he has seen more thorough heeling doing both rather than one or the other. I'm going to see him again tomorrow so I'll see if I can get him to elaborate. This was supposed to be my follow up appointment but I had to postpone surgery because my blood pressure and blood oxygen level were unacceptable at the pre-surgery physical. It's likely that it was caused by the stress of the approaching surgery. I'll post what answer I can get out of him tomorrow.
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Re: When is a fissurectomy needed instead of just LIS?

Postby hopefulbutt » 17 Jul 2013, 21:25

So should we be asking for a fissurectomy?
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Re: When is a fissurectomy needed instead of just LIS?

Postby Luka » 17 Jul 2013, 23:44

I posted this question a few months ago, but thank you for the answers everyone! : ) I've never gotten LIS and hopefully will never need it, but I was just curious. It seems like LIS (or Botox) and fissurectomy are frequently done together from what everyone is saying. I guess that just freaks me out since I would assume the amount of pain after surgery would be a lot worse due to cutting the scar tissue out and creating a larger wound. But if it helps healing, then it should be worth it in the end.
Even if you have some scar tissue, though, you should still be able to heal, right? Isn't that what scar tissue is for? I'm healing naturally, so sometimes I worry if any scar tissue there might pose a problem. I can't really feel anything, though, except maybe the skin being a bit more rippled, if that makes any sense. I can't really feel a sentinel pile anymore, either. It's still sensitive there, though, and I get mild twinges of pain every so often. When does the sensitivity go away? I still get tailbone and vaginal pain, too, which is annoying. It's nothing compared to when I first developed the fissure, though.
Happy healing, everyone! :) 
January 2013 - Diagnosed with fissure. Eventually turned chronic.
History of IBS and anxiety disorder, along with fear of using bathrooms other than my own caused it.
Tried Diltiazem, but eventually developed a rash.
LIS surgery scheduled August 26th.
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Re: When is a fissurectomy needed instead of just LIS?

Postby WelshDoubleFissure » 18 Jul 2013, 00:30

I've had a double fissurectomy and Botox AND a sentinel pile removed. After surgery I had no pain at all. They had applied an anaesthetic all over the area so I felt nothing. It was an odd feeling. I was expecting to be in agony.
4 days later I had a large BM and that's when the pain hit me. 10/10 during as the incision sites were all fresh and open. It was quite traumatic. I then had pain AFTER most BMs for 2 weeks after but not during the actual movement. It was a numb pain though.
If you have a lot of scar tissue, the wound is less likely to heal. There wouldn't be much to cut away as fissures can be relatively small.
I'm 5 weeks post op and I've had 10 days consecutively with no pain during a BM. Would I do it again? Definitely.
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Re: When is a fissurectomy needed instead of just LIS?

Postby Luka » 18 Jul 2013, 00:47

Welsh - Ouch! Sounds very painful! Did you take any pain meds like Vicodin, at least? You're very brave to go through all that. I'm not sure if I could do it, although if I was in a ton of pain with the fissure, I would have no choice, I suppose. Did you have a lot of pain with your fissures before having surgery? Like constant stabbing pain? Or was it milder? I only had stabbing pain in the beginning (last December), but now it's more dull pain and I've never had pain during BMs, even during the worst of times. It might sting a bit, but that's about it. Some days are worse than others, especially if I'm under a lot of stress or if it's during PMS/period time. Controlling stress is the hard part for me.
I'm so glad to hear you're doing better and on the road to healing once and for all. : )
January 2013 - Diagnosed with fissure. Eventually turned chronic.
History of IBS and anxiety disorder, along with fear of using bathrooms other than my own caused it.
Tried Diltiazem, but eventually developed a rash.
LIS surgery scheduled August 26th.
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Re: When is a fissurectomy needed instead of just LIS?

Postby WelshDoubleFissure » 18 Jul 2013, 01:17

I was told to take paracetamol and ibuprofen. These however would likely cause constipation so after the pain subsided enough I stopped taking them.
Before surgery, every BM felt like passing razor blades. After 3 years whilst being treated for it, I developed another fissure. I'd be in pain for about half hour after a BM. If I didn't have a BM for 2 days I wouldn't be in much pain.
The last 4 weeks before my surgery (I only managed to get a date 2weeks prior to surgery) was incredibly painful everyday.
The most pain I've ever had was my first couple of BMs after surgery. If anyone is in the same type of pain I was where it was affecting my daily life and deteriorating then I'd recommend surgery or atleast Botox.
The quicker you nip it in the bud, the better. Otherwise you'll be stepping further away from healing.
My routine is great right now for healing. My period has an affect on my routine and my stupid selfish uterus takes more water from my digestive system at that time and could cause constipation, so up your intake of water during this time.
Welsh x
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Re: When is a fissurectomy needed instead of just LIS?

Postby GeorgeTheCatMan » 18 Jul 2013, 15:26

Just got back from the crs. He said that my fissure has shown some signs of healing, but just slightly and it's still my call as to when I feel that I should have the LIS and Fissurectomy. I asked why he does both procedures; he said that the fissurectomy gives him a chance to biopsy the fissure, smooth the edges around the sore, which in turn speeds healing. The LIS is to relax the internal sphincter muscle, helping create a healing environment for the fissure to begin healing.
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