An anal fissure is a tear in the skin inside the anal canal. When this skin is torn, you may have pain with each bowel movement and pass bright red blood. Anal fissures can be acute or chronic. An acute fissure is a superficial tear and a short-term condition. A chronic fissure is deeper and may expose underlying muscle. When lifestyle and diet changes and medication fail, and the condition become chronic, surgery is recommended. A lateral internal sphincterotomy is the surgical procedure most commonly used to repair a fissure.
You will be given anesthesia medicine to make you comfortable and pain free during your surgery. Your sphincterotomy may be open or closed. During an open sphincterotomy, your surgeon will cut into the skin tissue covering your sphincter. This will allow him to see your sphincter muscles. He will make his cut away from any anal cracks or tears.
During a closed sphincterotomy, your surgeon will cut the sphincter muscles without cutting through the skin tissue. He will use a special scope to help him see your sphincter. If you have anal stenosis, the surgeon may make one or two cuts in your sphincter. Once your sphincter is incision, the pressure will be released and the muscles will relax. After your sphincterotomy, the surgeon will either close the cut with stitches or leave it open to heal. Your anus may then be covered with a bandage.
Usually after a sphincterotomy, your fissure should heal within 2-4 weeks, and is hoped that it will not return. However, we cannot assure that you will never get another fissure, and in a few cases they do return.
Faecal incontinance can be a surgery side effect and occasionally there is more difficulty in cleaning the anal area after a bowel action. Few people also experience difficulty in controlling wind (flatus).
- Infection in surgical wound
- Redness, warmth, or swelling around the incision
- Drainage from the incision
Once the surgery is completed, you will be taken to a post-operative or recovery unit. Your length of stay will depend on the complexity of the procedure. Most patients return home on the same day.
Your doctor will explain the procedure for post-operative care. This will involve keeping the operated area clean and dry, eating a high fiber diet, drinking plenty of fluids, and using stools softeners.