Fissurectomy is one of the options to treat chronic anal fissures.
Some facts about Fissurectomy:
- Fissurectomy is used for patients with a high risk of incontinence, such as multiparous women, old age people, patients with the normal anal tone, and patients with a previous history of anorectal surgery.
- Patients with chronic fissures who are refractory to medical treatment can respond well to fissurectomy.
- An anal fissure is a small tear or split in the skin around the anus.
- A fissurectomy may be recommended if you have an anal fissure and it hasn’t healed with self-help measures and medical treatments.
- Anal fissures are relatively common and can cause severe pain while you’re going to the toilet.
- The pain may continue for up to a couple of hours afterwards and they can also cause bleeding.
- Usually a fissure develops when the sphincter muscles that control when you poo, spasm and tense up which reduces the blood supply to the area, and hence stops the tear from healing properly.
- Anal fissures can be caused by constipation also.
- Usually, anal fissures heal within 6 to 8 weeks by using self-help measures such as eating high fibre foods, drinking more, and taking medicines to soften your poo.
- You can ease the symptoms by taking over-the-counter painkillers and warm baths
Preparation for Fissurectomy:
- You need to stop taking medications that may thin your blood, such as ibuprofen (Advil) or aspirin a few weeks before your surgery.
- You should stop smoking temporarily or permanently if you’re ready to quit as smoking can make it harder for your body to heal after surgery.
- You need to wait for any existing flu, fever, or cold to break.
- Most of your diet should be replaced with liquids and laxatives should be taken to empty your bowels.
- You may also need to only drink water or other clear liquids, such as broth or juice in the 24 hours before your surgery.
- Do not eat or drink anything for up to 12 before the surgery.
- Any medications that your surgeon gives you should be taken right before surgery.
Procedure for Fissurectomy:
- Fissurectomy is done alongside Botox injections which involves cutting away the damaged skin from around the anal fissure.
- Usually, Botulinum toxin (Botox) is used to treat conditions that cause muscle spasm.
- The medicine can be injected into the sphincter muscle in your bottom, which helps it to relax and in turn helps the fissure to heal naturally.
- A Botox injection will be offered before Fissurectomy.
- Botox is given as an injection under general or local anaesthesia.
- A second set of injections may be required three to four months after the first one for the fissure to heal completely.
- You may have problems controlling your bowels, when you poo or when you pass wind which is usually temporary.
- Botox can spread to other parts of your body resulting in weakness in your muscles and difficulties with breathing. But, this is very rare.
