Lateral Internal Sphincterotomy

Lateral Internal Sphincterotomy

This document 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).

Diagram showing the position of an anal fissure

Figure 1 - Position of anal fissure

What are the benefits of surgery?

Surgery is effective at treating an 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. The operation is usually performed under a general anaesthetic and takes about a quarter of an hour.

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?

General complications

  • Pain
  • Bleeding
  • Infection in the surgical site (wound)

Specific complications

  • 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.

 

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.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice. 

Most people make a full recovery and can return to normal activities. The fissure can come back.

Summary

An 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 © 2011 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.

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