Chronic anal fissure (a tear in the lining of the anus) is generally treated in a procedure called a 'lateral internal sphincterotomy', where initial non-surgical treatment has not helped.
Anal fissures form due to reduced blood flow caused by a recurring spasm in the muscle of the internal anal sphincter.
How should I prepare for surgery?
The day before admission we will contact you to confirm admission time and to give you instructions regarding any fasting requirements for the procedure. You should bring any x-rays in with you (and ensure you take them with you when you are discharged). Also bring any current medication in with you to the hospital.
For day procedures you should not drive yourself home when you are discharged - please ensure you have made other transport arrangements.
If you smoke, you should reduce smoking before your procedure. Our strong recommendation is that you give up entirely at least 6 weeks before the procedure, or at least one week beforehand. Smoking greatly increases the possibility of chest infection and hampers natural wound healing.
In the case of major surgery, please inform Dr White's team if you take:
- Anti-inflammatory medication.
We will need to discuss these medications with you prior to your surgery.
Dr White will provide you with a full set of pre-operative instructions for your specific surgery well ahead of the day of surgery.
What is involved in the procedure?
A sphincterotomy involves making a small cut to a specific part of the anal sphincter muscle, which in turn increases blood flow to the tissue affected by the fissure - this then permits the fissure to heal naturally.
Check the recovery guidelines section on fissure surgery for more details.
All types of surgery are subject to the following risks, which are rare, but can occur:
- Allergic reaction to medication / anaesthetic
- Difficulty breathing.
Complications after sphincterotomy surgery can also on rare occasions include:
- Small abscess development (~2% risk).
- Fistula development (<1% risk).
- Fissure not healing / recurring* (1-6% risk).
- Problems urinating.
* studies indicate that around half of all patients with non-healing / recurring anal fissures have undiagnosed Crohn's Disease.
When to contact Dr White
Most surgical procedures are uneventful, with minimal complications. However, you need to be aware of the following symptoms as they may indicate a developing serious complication...
- Excess bleeding.
- Difficulty urinating.
- Severe or increasing pain.
If you experience any of these symptoms or have any concerns after your surgery, please contact the rooms on 07 5598 0955 for advice.
A post operative appointment will be made for you before you are discharged from hospital. If you are discharged on a weekend, after normal surgery hours or it is not clear what follow up appointments are required, then contact the rooms the next working day to make an appointment.