p.s. also hoping to start hyperbarics if my insurance will pay.

Hi, I didn't have house advancement flaps. Mine were bilateral flaps that were in the shape of a U and the donor sites were left completely open so there would be no tension on the area when it healed. I finally go† up the courage to look at the pictures and I'm glad I didn't look at them when I first had it done. I had a fissure and stenosis. The hemmie surgery set me up for stenosis, they just took too much tissue. It snuck up on me though. I got my first fissure and it healed in a few weeks. The second one didn't I had it a year then had LIS, that healed the fissure for a short time but the stenosis didn't allow it to stay healed. I kept tearing and healing and tearing and healing. All this time scar tissue was building. I did this for 5 years. I finally went to the CRS because I couldn't pass a piece of corn or a pea. It would actually get stuck. I was in a lot of pain too. I had my advancement flaps last april. Healing from that took quite some time but the surgery was the best thing I did. I'm still very careful but most of the time I feel good. The area can get irritated easily but what can you do. The surgery removed the fissure (6 O'clock position), the skin tags (and I had a lot of them) and quite a bit of scar tissue. The new skin was place over where the fissure and scar tissue were removed. I do dilation once a day to stretch the area, it really helps keep the new tissue stretchable and it's part of my recovery. I still take miralax but only a half dose. My CRS does open flaps because sometimes when you heal the scar tissue from the surgery can get stiff and pull on the rectal area. Leaving the flaps open helps to avoid some of that. Suzy

Hi Suzy, do you remember how long it took for the blood to stop during bathroom trips?

p.s. If you had bi lateral flaps, how did they cover an anterior fissure? or was that an additional flap?

They cut the fissure out and made the flap big enough to cover it. My flaps were huge. They took a picture after surgery and you couldn't see much other than the donor sites. The only part of the anus that was visible was a little of the upper part. Like I said before I was lucky to find a surgeon who knew how to help me.
I had blood for 6-8 weeks. Then after that I had a discharge for a while. I remember having to use gauze for quite a while.

Hi Suzy,

I also had a stricture/stenosis following my hemm surgery...Other than the anterior fissure, what other symptoms did you have that you had stenosis/stricture and not just a fissure? Were BMs really difficult? Did the LIS you had help with the stenosis at all? Our stories sound very very similar except you had a much more invasive flap surgery than me, and I'm wondering if I needed more flap coverage in retrospect because I also had a stricture/stenosis from my hemm surgery.

The size of my stool was getting smaller and smaller. I always felt tight and the area didn't stretch without tearing. A lot of my symptoms are the same symptoms you get with a fissure so without the doctor examining me I didn't know for sure. I knew I was in trouble when I couldn't pass small pieces of food like peas or corn without them getting stuck on the way out. That's why I keep telling people not to let things go too long out of fear. If I would have gone in right away I would have only needed one flap but I put things off for over 5 years because I was so afraid.
I think they should warn you up front what can happen after a hemorrhoidectomy. Most hemorrhoids can be managed, mine were hemorrhaging and they couldn't stop it. I had to have 2 blood transfusions and surgery. In the course of surgery the doctor took too much tissue and that's what started me on this road.
LIS can help with mild stenosis, along with diet and stool softeners but that's a lifetime change because you can't stretch scar tissue. If you have severe stenosis surgery is your only option. Some people try dilation under anesthesia but it usually has to be repeated. Take care Suzy

Thanks for the info Suzy. I also had trouble going to the bathroom...but because I had hemmorhoids my whole life, after my hemm surgery, I thought that the difficulty going was just how it was for everyone else without hemmorhoids. I noticed my stool thinner too, and told my first CRS, but he said it was no big deal. In retrospect, I'm so shocked that my stenosis wasn't diagnosed sooner because I used to have to push A LOT to get even the smallest poop out. I'm surprised I didn't have a stroke pushing as hard as I was. Since the LIS, I have a much easier time going...

I'm starting Hyperbarics, hopefully tomorrow. I'm pretty nervous about it, so wish me luck. I'm going to try to go everyday for the next few weeks and hopefully heal this god awful anal wound for good. FYI, if you have a flap surgery, insurance does cover the hyperbarics, so it is definitely worth looking into it. My treatments are fully covered, which is amazing, as the place said it's about 10,000$$ after 40 treatments.

Good luck with the hyperbaric treatment. I looked into that here in the uk... But it would cost me thousands, and I can't get it on the NHS.
Keep us posted!
OMB x

quick update: Just got back from the hyperbaric center...I am massively claustrophobic and there's just not way I could sit in the that glass tube for 40 treatments at 1.5 hours each...I couldn't take 5 minutes without freaking out. It's really not that bad, I am just not good in confined spaces and there's not much I can do about it. I'm going to ask the doctor about drugging me up for next time, but I don't know if any amount of drugs will get me back inside that sealed glass tube. BUMMER.