If you have already tried all the possible home remedies for your anal fissure yet you were not healed, surgery may be necessary. There is no other solution but to undergo a surgery especially if the fissure has been there for a few months. More than 90 percent of people who have undergone surgeries for anal fissures experienced good long-term effect. It is generally considered to be the most effective treatment. However, this carries a small risk of complication.
There are different surgical treatments for this. Some of the well known surgeries and operation procedures for anal fissure treatment are anal stretch, or the Lord’s operation, lateral internal sphincterotomy (LIS) and advancement anal flaps. These surgeries reduce the sphincter spasm regulating a normal blood supply.
In lateral internal sphincterotomy, the internal anal sphincter is partially cut in the muscle ring surrounding the internal anal sphincter to improve the blood supply to the area. This also slightly weakens the sphincter which reduces the tension. LIS is usually a same-day surgery and is done with general anesthesia which means you will be asleep during the operation although there is no need to spend a night in the hospital. Patients often recover within one week.
However, some complications may occur such as:
- postsurgical pain
- development of acute, mild anal incontinence
- slow healing of the cut
- fecal loss
- fecal soiling
- inability to control gas.
The bowel incontinence is a result of the damage to the anal muscles. For the mild anal incontinence, keyhole deformities may be seen. The anal canal resembles an old-fashioned key. To reduce the possibilities of these complications, it is recommended to use of three stitches.
The use of lateral internal sphincterotomy allows the fissure to heal and reduces the chances of re-developing. It is short and simple operation which makes it one of the most effective treatments with a high-rate success.
Another possible surgery is the anal stretch (also known as Lord’s operation or anal dilation). This involves manually stretching of the anal canal in order to lighten the pressure. If performed correctly, this treatment can provide instant relief from anal fissures. The patients will maintain using an anal dilator for 6 months. This treatment also uses either general or localized anesthesia. But of course, there are risks that may occur such as anal leakage because of the excessive force used in the procedure. It also damages the sphincter and the rectal tissue and produces blood clot.
It is now an old method and less performed because of the high incidence of both fecal and gas incontinence, and higher failure rate.
In addition, dermal flap coverage is also considered as one of the well known surgeries and operation procedures for anal fissure treatment. Skin flaps are used to cover the fissure in this treatment. Doctors have found this of interest in the surgical treatment of anal fissures because of low possibilities of complications following this surgery.
There are other surgical treatments which are less common such as advancement anal flaps, tailored anal sphincterotomy and fissurectomy. Several possible surgeries are to choose from. It is best to talk to your doctor what you want to undergo and what is best for your condition.
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