Anal surgery Brisbane | Non-surgical treatment options include high fibre diet, stool softeners and topical therapy such as rectogesic, diltiazem or nifedipine. Dr Allison can discuss the options of the treatments. Sometimes these conservative measures do not cure the fissure.
Surgery for an anal fissure is called an internal sphincterotomy. A portion of the internal part of the anal sphincter is divided in an internal sphincterotomy. This reduces the sphincter muscle pressure allowing increased blood supply to the lining of the anal canal where the fissure is located resulting in healing of the fissure.
The risks are incontinence (never seen in Dr Allison’s practice as tends to divide too little rather than too much muscle), ongoing fissure pain (where Dr Allison has been too conservative with dividing muscle), and a wound infection of 1%. In those where the operation has not cured the problem, usually the instigation of the cream option will cure the problem. Occasionally, there is the need for further surgery, mostly in the form of a redo lateral internal sphincterotomy.
In some chronic fissures, it may be necessary to perform an advancement flap, where the skin of the perineum (skin around the anus) is advanced into the anus to cover the fissure.
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