I've just refused surgery on the basis that you are just an experiment with this operation, nothing is guaranteed and the fissure is likely to return if you don't keep to a strict diet. So you might just as well do that anyway and live with the problem, which is manageable with the right discipline. If you read stories from people who did not have a successful outcome you might come to the conclusion that the risk is not worth taking. Other people have good results and swear by it. But itís your body youíre gambling with.
Hi, no surgery is guaranteed 100%. I had LIS surgery for a really bad fissure in Oct. 2008. It's no more painful than the fissure already is. I was also afraid of incontinence but my surgeon has done this surgery many times and he said he's not had a problem with it. They still have to tell you all the possible complications though. After the surgery it took about 8 weeks for the fissure itself to heal. The LIS is to relieve the anal spasms so blood flow can reach the fissure and promote healing. Then I got an injection of a steroid directly into the fissure. That hurt more than the surgery itself.
It's true that after the surgery you have to keep your bms. strain free and on the soft side but that's life. Personally I would say if you're in so much pain it's interfering with your life go for the surgery. I wish I didn't wait so long. I still have occasional mild spasms of the sphincter but not like before. If you decide to have the surgery I wish you good luck and good health. Find a good CRS and trust him. Suzy.
I had LIS in October and was pain free immediately. Keeping a good diet is not difficult for me as I had always done so. I also consume lots of water every day. This too was not a change.
No surgery has a guarantee but studies do show that fissure recurrence after LIS to be 5-6%. I am extremely glad I had LIS. Just make sure you go to an experienced colo-rectal surgeon...that, I believe, is the key to success.
If you have any intention of getting better please read my post. I have suffered from a fissure for 1.5 years. It was suffered from a large hard BM and since then my life drastically changed. I became depressed, stopped eating for fear of going to bathroom, etc. im sure anyone with this problem knows the issues that come with it. I tried everything from diet changes, fiber, stool softener, blood pressure creams, schlerotic injection for hemorrhoids, analpram, and finally two weeks ago Botox. Botox was slightly painful and I had a little leakage after meaning i had to wipe about ten minutes after i first wiped but it was NOTHING to worry about. Botox also wears off. Botox, and this is the most important thing about it, DOES NOT WORK in most cases. It worked for a week with me and then my fissure tore open again. The doctor only suggested I try it as one last ditch effort before surgery. I went in for surgery yesterday and not only am i in no pain at all except for a little sting once in a while, but I went to the bathroom today pain free. As my surgeon said, all his patients ask themselves why the hell they didn't do the surgery sooner, including me. The surgery is a cakewalk and my recovery at least is non remarkable and even enjoyable. I was out shopping an hour after my procedure, albeit i couldnt feel my butt from the numbing injection. Get the surgery. The risk of anything going wrong in the hands of a skilled surgeon is none. If you are in LA I recommend Dr. Gary Hoffman. His team, office, and skill is second to none.
Hello, I had my LIS surgery today and so far so good. I was one of the unfortunate ones that had spasms for 6-8 hrs after every BM. I had passed really hard stool on 3/25/2010 and it caused the fissure. My life changed for the worse that afternoon. I haven't been able to leave the house in the last 14 days because I would be in so much pain after a BM. I would have to soak in a tub of hot water multiple times a day for hours and sometimes that didn't work. I tried lidacain (sp?) w/ hydrocortizone and nifredipine (sp?) creams and they did absolutely nothing. I saw my surgeon a week and a half ago and he said that my fissure had become chronic but I would not need a fissurectomy if we I decided to have the LIS surgery now. I decided that I would deal with the incontinence, if it happened, over the pain. I was depressed and had multiplle emotional breakdowns because of the pain. As of the beginning of this week, my BMs were actually ok. However, as soon as I would get up, the spasms would kick in and I would be down and out for the rest of the day.
As far as diet, My NYE's goal this year was to get my weight down from 205 to 175. I hit my goal just before the fissure. Now I weight 162 because I've been afraid to eat because I didn't want to go to the bathroom. My surgeon said I had a "text-book" case and he feels extremely confident the fissure will heal now that I don't have the spasms. Another reason why I went ahead with the surgery is I didn't want the fissure to get deeper and start ripping the muscle fibers.
You really have to decide if the surgery is for you. Some people don't experience the spasms so they are able to heal by the diet change. I was not one of them so I decided to get it done sooner than later. I know there is a chance the fissure can return but I'm willing to take that chance right now.
Whatever you choose, goodluck and as many people will say, make sure you feel comfortable with your surgeon. My surgeon said that he has never had issues with incontinence.
I will post more over the next few days providing updates on my recovery. My surgery was this morning around 10 am. I'm still waiting for my first BM so I won't really know if I'm pain free until then.
Please feel free to ask any questions you might have. I'm not a doctor but I did stay at a Holiday Inn last night
Day 3 since my LIS surgery and I feel like a new man!! I had my first post-op BM around 4:15 pm Sat and I cried for joy. I haven't experienced any pain and very little symptoms from the procedure. The only thing that has changed is I don't go into spasms for 5-8 hrs after every BM. I feel 85% and think it will be close to 100% in another couple days.
Unlike most people, I took my pain pills as prescribed. I had 2 nurses tell me the pain is much easier if you stay ahead of it so I started as soon as I got home. I pretty much took something every 4 hours. Either way, there was no way I was going to go through what I had been going through when I had "happy pills" in my posession.
I only dealt with my fissure for 4 weeks but it was the worst thing I have ever dealt with. The pain was unbearable at times and I truly wondered if I would ever get through it. I would pick the surgery again if I had to, 100 out of 100 times.
If you having been dealing with this for a long time, I highly suggest talking with your doctor. The pain isn't worth it.
This all makes me kind of concerned, as I suffered from a fissure as well as hemorrhoids for years. I had the PPH surgery in late 2002, which went very well, and I've had no trouble since. In March of this year I went through a period of high-stress, and apperently became somewhat constipated. After 8 years of being diligent about making sure I was eating plenty of fiber, etc., with great success, this happened. Then I pulled a stupid...I strained to eliminate a few hard stools - I knew better. I developed that familiar burning, searing pain which used to just wear off in a couple of weeks, but now it's been over five weeks and it's worse. The pain is so intense it's hard to concentrate, and I've lost 15 pounds over the last month, simply because it kills my appetite. Went to a colorectal surgeon yesterday, and he prescribed me the Nifedipine cream, and said if things weren't better in four weeks to come back and we'd discuss surgery. I'm hoping since this thing has shown the ability to clear up in the past that the cream, extra fiber and water, sitz baths, etc., will fix it back up. For the record, the exam in his office was the most excruciating pain I've ever felt. One of my bigger concerns about the surgery deals with the fact that I was laid off last year, and don't have health insurance at my current job. So not only will I get the pain in the rear after surgery, I'll get to foot the bill for the surgery as well as however much time I have to take off work without pay (no paid leave, either). Has anyone had success with the Nifedipine, or am I doomed?
What is the PPH surgery? I'm 3 days away from being 3 weeks out from my LIS surgery and so far so good. Is the LIS the same as the PPH? I was in agonizing pain after BMs for hours. It got to the point where soaking in warm baths for 3-5 hrs weren't helping. Went with the surgery exactly 4 weeks and 1 day from the day that "changed my life for a month".
I hope things get better as I think I know the pain. I have no regrets and I would pick LIS surgery 100 out of 100 times if given the option of that or the pain. Keep us posted...
PPH is the stapled hemorrhoidectomy; had it in 2002 for prolapsed hems that bled profusely and had to be "put back" after BMs, and it was a breeze - and my fissure pain never returned after it....until now. Had a period of high stress that for whatever reason constipated me, and rather than deal with that the proper way, I just strained here and there and put myself in this position. I've been on the Nifedipine for less than a week, but it's not doing much, so I think I'll call today and see if they'll schedule me for surgery. I don't want to do it, but I can't live like this. As has been mentioned on this board many times: "I want my life back".
For the record, York; your story (other than I had either this or another fissure years before) almost exactly mirrors yours, to the date - late March is when my terror started. I have a surgical consult next Tuesday, and I pray I have the same outcome (and recovery time) you seem to be having.
I hope the consult goes well. I will be back on the boards Mon. evening with an update on my visit with the surgeon. I'm anxious to hear what he has to say after he has a chance to see the fissure and how it is healing. That is my primary concern now and it all seems to be going well as of now...
Glad you're doing fine. I talked with the nurse today at my colorectal surgeon's office, and she said sometimes it takes a couple of weeks or more for the Nifedipine to work...maybe I'm jumping the gun, and should give it more of a chance. The pain pushes me towards surgery, just to get some relief, but the thought of risking incontinence at 42 years old (with two young boys to play with) makes me pull the brakes a bit. This has healed before without surgery; but it usually healed up in a couple of weeks - not six. I'll see how I'm feeling over the weekend, and see if I want to postpone that consult for another week or two. Just wish I wasn't in this situation. Come ooonnnn, Nifedipine!
I had the same fear as you...am I jumping the gun? I asked my wife every night for 2 1/2 weeks. It would feel better at night and then I would think that ok, this isn't bad. Then it started over. But I had to ask myself, would my next BM after it "healed" be the one to put me right back in this situation? That was the question that really helped me take the next step. My employer was extremely cool and allowed me to work from home for 3 weeks and then another week after the surgery. However, I can't go through this again...emotionally and physically. I know I have a chance of the fissure re-occurring but I was more concerned about the pain of the muscle spasms.
I saw my surgeon for my 3 week and 3 day follow-up. He said the incision area is healed and the fissure is probably 85% - 90% healed. He said I couldn't ask for a better scenario as far as healing. Maybe another couple of weeks for the fissure to be healed. I can't imagine what I would have done if I got this far prior to the surgery and then had a set back with the pain starting all over. That is why I went for the surgery. I feel great and the "cleanliness" issue I had discussed earlier in some other posts seems to be gone as I haven't had it for the last 3 days.
As I told my surgeon, he gave me my life back and I can't thank him enough. I still find it hard to believe I had the surgery because I honestly didn't have any pain after the procedure. It was like I actually woke up from the nightmare.
Hope things continue to progress. My muscle spasmed so badly that I couldn't apply the cream you have where it needed to be applied. I would get nauseaus from the feeling of the pain while I tried to apply the cream. Hopefully you aren't having those feelings