Surgical indication for anal fissure
Surgery can be proposed in case of old fissure anal resistant to medical treatment or complicated.
Two types of intervention are possible:
Ablation of the anal fissure: this technique consists of removing the bottom of the fissure and covering the wound with healthy mucous membrane (anoplasty) allowing good healing. The healing time is quite long (six weeks). This method does not cut the anal sphincter.
A partial section of the internal sphincter: This sphincterotomy is performed under general anesthesia when the patient has a spasm of the external sphincter of the anus. This technique can be performed in the bottom of the fissure or away from the fissure (lateral sphincterotomy).
Operative follow-up for anal fissure
The pain subsides within a week and healing is achieved in 5 to 6 weeks. The risk of recurrence is 5%.
Anal fissure incidents
Anal continence can be degraded. This problem improves with healing. Unfortunately, incontinence persists permanently in about 8% of patients. This problem essentially concerns gas continence. Seeping may also occur but this problem is transient.