Peri-Anal Fissure

An anal fissure is a small tear running from the skin near the back passage and opening into the anal canal higher up. This is a painful condition usually associated with fresh bleeding after bowel actions. The fissure is aggravated by spasm of the circular anal muscle. The operation involves either stretching or cutting into the sphincter muscle a little to relive the spasm and thus the pain, allowing the fissure to heal. Any associated anal skin tags are removed

WHY IS THIS OPERATION NECESSARY?

The blood supply in this area is often poor, and this pre vents healing. An acute fissure can then become chronic and continue causing pain or bleeding.

SPHINCTEROTOMY
SPHINCTEROTOMY

ARE THERE ALTERNATIVE TREATMENTS AVAILABLE?

Once a fissure has become chronic, there is very little chance that it would heal without releasing the muscle spasm with an operation. There are ways to relax the muscle by using special ointments or injecting botox but these have a higher failure rate than the stretching or cutting of the anal sphincter.

IS IT SAFE TO HAVE THIS OPERATION?

Before you agree to the operation, you should consider the risks that may be involved. Your surgery will be per formed by a team of highly qualified and skilled professionals who will take all steps necessary to ensure a safe procedure and a successful result.

However there are risks involved with all surgery even if these risks may be small.

WHAT ARE THE GENERAL RISKS INVOLVED?

There are risks for developing complications which are general and which may occur with any surgical proce dure. These complications include the risk of infection, bleeding, pain, wound breakdown, deep vein thrombosis, or complications affecting the heart, lungs or kidneys.

WHAT ARE THE SPECIFIC RISKS INVOLVED?

There is a small chance that the external anal sphincter muscle is damaged causing weakness with loss of function. Later complications may occur such as an anal stricture or narrowing of the anus opening. The chance of the fissure coming back again is small. After cutting the anal sphincter there is a 5% risk of loosing control of wind.

WHAT ARE THE ANAESTHETIC RISKS INVOLVED?

You can discuss the type of anaesthetic you will have with your anaesthetist and also the possible complica tions that may occur.

WHAT SHOULD I DO BEFORE THE OPERATION?

You should not eat or drink anything for at least six hours before your operation. However, you should take all your regular medication as usual on the day. Your surgeon may want you to stop certain medication such as disprin, warfarin, or other blood thinning medicines before the operation.

Sometimes the surgeon will ask the nurses in the ward to give you an enema before you go to the operating theater

WHAT HAPPENS BEFORE THE OPERATION?

Please report to the hospital reception on time for your admission. Please bring along all the documents that may be required such as your medical aid card, ID and con