What is fissure anale?
An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. An anal fissure may occur when you pass hard or large stools during a bowel movement. Anal fissures typically cause pain and bleeding with bowel movements.
How fissure operation is done?
In an open sphincterotomy, the surgeon makes a small cut in the skin to reach the sphincter muscle. Once the sphincter muscle is visible, the surgeon cuts into it. In this method, the incision may be left open to heal. In a closed sphincterotomy, the surgeon passes a blade under the skin to access the sphincter muscle.
What is sphincterotomy procedure?
If your anal fissure fails to respond to other treatments, your doctor may recommend an anal sphincterotomy. This surgical procedure involves making a small incision in the anal sphincter to relax the muscle. Relaxing the muscle allows the anal fissure to heal.
How do you perform lateral internal sphincterotomy?
In the open approach, a small incision is made in the left or right side of the anal skin to expose the internal sphincter muscle fibers. The surgeon lifts up the internal anal sphincter muscle and divides it using a knife or thermal cautery.
Which medicine is best for fissure?
What is the best medication for an anal fissure?
| Best medications for anal fissure | ||
|---|---|---|
| Aspercreme Lidocaine (lidocaine cream) | Anesthetic | Topical |
| Rectiv (nitroglycerin cream) | Vasodilator | Topical |
| Nifedipine cream | Antihypertensive | Topical |
| Botox (botulinum toxin A) | Neurotoxin | Injection |
Is a sphincterotomy permanent?
Yes, a sphincterotomy is permanent. It is surgery to permanently release the sphincter muscle of your anus.
Can fissures come back after surgery?
Approximately 1-6% of patients have a recurrence of their anal fissure after sphincterotomy. The recurrence rate is higher after a sphincter stretch. If a patient develops a recurrence after a sphincterotomy, it could be from recurrent disease or from an improperly or incompletely performed initial sphincterotomy.
What kind of anesthesia is used for sphincterotomy?
Lateral internal sphincterotomy is the current surgical procedure of choice for anal fissure. The procedure can be performed with the patient under general or spinal anesthesia. (Local anesthesia may even be used in the cooperative patient, though it is not always recommended).