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It seems that doctors in the U.S. (and anglophone countries in general) still prefer the LIS (sphincterotomy) procedure as the surgery option. This was offered to me years ago and I rejected it for fear of even minor incontinence. It was helpful for me to get a change of perspective during my recent treatment in Paris and other countries in Europe.
According to the proctology institute in Paris I have been treated at, most French doctors now avoid the sphincterotomy procedure due to the incontinence risks. I have read similar information on German websites.
The older procedure, the fissurectomy, which involves actually cutting out the fissure, is more commonly practiced here. For us laypeople, it's hard to understand how a larger cut on the butthole will cure a fissure, but apparently it is effective, although maybe less so than the LIS. The fissurectomy recovery process sounds dreadful, but there is not really risk of incontinence.
Of course, many people rave about their LIS surgery. It clearly is effective, but for me not worth the risk. I was happy to hear of another option, in case it comes to that.
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