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Date of last update: 8/19/2017.

Forum Name: Surgery Topics

Question: Recovery after Sphincterotomy/Fissurectomy

 butters13 - Wed Dec 16, 2009 10:20 am

Hello. I am 23 years old and I suffered from an anal fissure for 10 months. I tried many forms of treatment and finally decided on surgery to relieve the intense pain (the pain was a 10 on a scale from 1-10). I had my surgery 5 days ago (Sphincterotomy and Fissurectomy). I have had 4 bowel movements since the surgery and I am still in a lot of pain. My Doctor told me that the pain caused by the fissure would be relieved immediately, but it doesn't feel like that is the case. I also have had pain from the incision constantly throughout the day since the surgery; it is hard to walk, sit, sleep, etc. I took Vikodin for the first two days but decided to stop do to very hard stools, I have been taking Advil to try to control the pain but it doesn’t really help that much.

The first three bowel movements after surgery were very painful because they were quite hard and I had to strain to get it out (even though I have been taking fiber supplements, drinking a lot of water and taking stool softeners since the surgery). The fourth bowel movement was softer but there was still a lot of pain. There is hardly any blood. I am not sure if the pain is from the fissure or from the incision. My Doctor made me believe that the pain would be gone almost immediately from the fissure so I expected recovery to be a breeze, but so far that has not been the case. I opted for the surgery to get rid of the intense pain during bowel movements, but the pain is still persisting. Is it normal to be in this much pain still? How long will it take for the pain from the incision to go away? Once that pain is gone, will I still have pain from the fissure? Or will I be pain free?

Also, I was prescribed nifedipine ointment before my surgery to attempt to heal the fissure... is it okay to use this after my surgery to help the healing process?

I’m in a lot of pain and I need help.
 Dr.M.Aroon kamath - Thu Dec 24, 2009 4:36 am

User avatar Hi,
There are a number of surgical procedures done for chronic anal fissures.

- fissurectomy(not preferred by most),but at times done if an associated fairly large skin tag(sentinel pile) needs to be removed.
- sphincterotomy(lateral or median)-- lateral sphincterotomy can be by an 'open' or 'closed' technique.

The idea underlying sphincterotomies is that by dividing the fibers of the 'internal sphincter', one is able to get over the spasm of this muscle, which is believed to be the inciting cause for
- the pain &
- the chronicity (non-healing nature) of the fissue.
You have not indicated what type of sphincterotomy was done in your case."closed' sphincterotomies tend to cause less pain post-operatively.
Post-operative pain is variable depending on variables such as
- the type of surgery done,
- pain threshold,
- analgesic drug used and dosage,
- the consistency of the stool etc.
Your pain should hopefully abate quite soon.Consult your surgeon again if your stools are hard or you have to strain excessively.
Best wishes!

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