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Lateral internal sphincterotomy

3-minute read

This page will give you information about a lateral internal sphincterotomy. If you have any questions, you should ask your GP or other relevant health professional.

You can also download and print a PDF version of this factsheet, with space for your own questions or notes.

What is an anal fissure?

An anal fissure is a tear in the skin around your 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.

What are the benefits of surgery?

Surgery should help the anal fissure to heal but is usually recommended if the fissure has not healed with non-surgical treatments.

Are there any alternatives to surgery?

There are simple treatments which may help such as laxatives, ointments, injections of Botox, increasing the amount of fibre in your diet and drinking plenty of fluid.

What does the operation involve?

Sphincterotomy simply means dividing the sphincter. The operation is usually performed under a general anaesthetic and takes about 15 minutes.

Illustration showing lateral internal sphincterotomy
Lateral internal sphincterotomy

Your surgeon will make a small cut on the skin near your back passage. They will 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 of the surgical site (wound)

Specific complications

  • involuntarily passing wind or loose faeces
  • difficulty passing urine
  • permanent incontinence from your bowel

How soon will I recover?

You should be able to go home the same day. The pain from the fissure should improve rapidly. You should be able 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, ask 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 Botox. If this fails, surgery is the best option for a cure.

IMPORTANT INFORMATION
The operation and treatment information on this page is published under license by Healthdirect Australia from EIDO Healthcare Australia and is protected by copyright laws. Other than for your personal, non-commercial use, you may not copy, print out, download or otherwise reproduce any of the information. The information should not replace advice that your relevant health professional would give you.

For more on how this information was prepared, click here.

Last reviewed: September 2018

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Anal fissure - Better Health Channel

Around half of cases of anal fissures heal by themselves with proper self-care and avoidance of constipation.

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