Lateral Internal Sphincterotomy
This webpage will give you information about a lateral
internal sphincterotomy. If you have any questions, you should ask
your GP or other relevant health professional.
What is an anal fissure?
An anal fissure is a tear in the skin around the back passage.
It is a common problem that causes severe pain, especially after a
bowel movement. It may also cause bleeding.
The condition is associated with spasm of the internal anal
sphincter. This reduces the blood supply to the area and prevents
healing. The treatment is aimed at breaking this cycle to allow
healing to take place (see figure 1).
Figure 1: Position of an anal fissure
What are the benefits of surgery?
Surgery is effective at treating anal fissure but is usually
recommended to people who fail to get better with non-surgical
treatments.
Are there any alternatives to surgery?
There are simple treatments which may help such as laxatives,
ointments, injections of botulinum toxin, eating more fibre and
drinking more fluid.
What does the operation involve?
Sphincterotomy simply means dividing the sphincter. It is
usually performed under a general anaesthetic.
Your surgeon will make a small cut in the skin near your back
passage. They will then cut the lower part of the internal
sphincter muscle. This will relieve the spasm in the sphincter,
allowing a better blood supply to heal the fissure.
What complications can happen?
1 General complications of any operation
- Pain
- Bleeding
- Infection in the surgical wound
2 Specific complications of this operation
- Involuntarily passing wind or loose faeces
- Difficulty passing urine
- Permanent incontinence from the bowel
How soon will I recover?
You should be able to go home the same day or the day after.
The pain from the fissure should improve rapidly. It is usually
possible to return to work after a few days depending on your type
of work.
Most people make a full recovery and can return to normal
activities.
Occasionally the fissure comes back.
Summary
Anal fissure is a common condition that causes a lot of pain. At
first, it may be treated with ointments or botulinum toxin. If this
fails, surgery is the best option for a cure.
Acknowledgements
Author: Mr Ayan Banerjea MRCS, Mr Jonathan Lund DM FRCS (Gen.
Surg.) and Miss Gillian Tierney DM FRCS (Gen. Surg.)
Illustrations: Medical Illustration Copyright © 2006 Nucleus
Medical Art. All rights reserved. www.nucleusinc.com
This document is intended for information purposes only and
should not replace advice that your relevant health professional
would give you.
Copyright © 2008 EIDO Healthcare Limited
The operation and treatment information on
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The information should not replace advice that
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