Fissurectomy vs. sphincterotomy

Posted , 5 users are following.

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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4 Replies

  • Posted

    Hi, LIS seems to be the gold standard in Australia. I’ve recently had it done. 
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  • Posted

    Lis is much preferred option than fissurectomy. Chances of fecal incontinence are very less. It much depends on experience of surgeon who operates. There are 4 anal sphincter muscles 2 ext and 2 int. In lis they cut a portion of our one internal sphincter which had cause spasm. Internal sphincter are not under our control. But as external sphincter have no damage chances of fecal incontinence is very less. External sphincter have 70% of control. Hope this clears.
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    • Posted

      I’d wear a nappy if I had to, to lose the fissure pain I had!!! It was the worst time of my life!! I had no issues with incontinence since surgery. My fissure is still there 3 months on from surgery but only small pain amount now after bm only. Better than 12 hours a day 3 months ago. I still believe the right creams and diet can heal without the surgery and I’m still using a combination of creams! Possibly that’s why I healing and not from the surgery... btw Botox did nothing at all! 
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  • Posted

    can you please write about the post surgery experience and recovery process?

    i have a chronic fissure that reopened now . it took me almost 3 months to heal after a bad episode last year. I am upset that l in the past months since I finally healed, just a nothing push may open the fissure again. that is what apparently happened about a week ago.

    i have been using all the remedies available and following a good fiber routine plus lots of water. its healing but slowly.

    my concern is getting more tags. could tags affect how BM comes out?

    I would very much like to hear about your (or anyone else's reading this) surgery experience, recovery and all.

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