The operation aims to prevent the sphincter going into spasm, so restoring normal blood supply to the anal canal, helping the anal fissure to heal and reducing the chance of developing more fissures.
Lateral sphincterotomy has a very good rate of success in treating anal fissures.
During a lateral sphincterotomy a small cut is made in the ring of muscle (sphincter) around the anal canal. This reduces tension in the anal canal, allowing the anal fissure to heal.
It is a relatively quick and simple procedure normally carried out under a general anaesthetic. This means you'll be asleep while the operation is carried out but you’ll usually be allowed home later the same day.
Some discomfort is to be expected and we’ll give you painkillers to relieve any pain. You may be advised to make some dietary changes and perhaps take some laxatives to avoid becoming constipated and to make your stools easier to pass.
You will probably have a dressing on your wound which may need be changed daily. We’ll make all the arrangements for this to happen before you go home.
You’ll need to take some time off work and should avoid strenuous exercise until advised. You should be fully healed within two to four weeks and, in most cases, the anal fissure will not return.
A lateral sphincterotomy is usually very effective in treating anal fissures, although in a few cases they do return. Some people will experience some temporary bowel incontinence because of damage to the anal muscles. However, this is usually just wind incontinence which only lasts a few weeks.
Non-surgical treatment is recommended initially for anal fissures, whether acute or chronic (those lasting six weeks or more). Anal fissures typically heal within a few weeks without any treatment. However, if they're caused by constipation that remains untreated, they can recur.
A first step may be to help yourself avoid constipation. Make sure you have plenty of fibre in your diet - this is found in foods such as fruit, vegetables and wholemeal bread, rice and pasta. Try to stay well hydrated by drinking plenty of fluids. Make sure you exercise regularly and, finally, don’t ignore the urge to open your bowels as this can cause your stools to dry out and become harder to pass.
If you’re suffering from pain, you can take simple painkillers such as ibuprofen or paracetamol. A soak in a warm bath may help - do this several times a day, particularly after a bowel movement.
Your GP may also prescribe other medication to help relieve your symptoms and aid healing. For example, laxatives may help your stools to pass more easily and ointment, applied directly to your anus, may help relieve pain.