Medical terminology used for Fissure surgery is Sphincterotomy. This medical condition is very common in young adults. Women after childbirth may also suffer from this problem. Infants show some symptoms of anal fissures, that are usually cured with proper medication. Surgical treatment must be the last resolve to such problems; when all prescribed medicines and ointments fail to deliver effective result.
The process mos commonly employed to treat anal fissure is known as sphincterectomy. General anesthesia is used to perform the surgery. The sphincter muscle (relaxes and contracts anus while passing stool) is cut to relax it. This will reduce over-stretching anal mucosa while passing stool, which helps the fissure to heal. The surrounding damaged anal mucosa is surgically excised.
The anal fissure usually develops when the anal tissue is damaged during a hard and dry bowel movement which tears the anal lining.
The anal fissure can also develop due to higher than normal pressure in the anal sphincters. Diarrhea and inflammation of the anorectal area can also cause an anal fissure.
Many women during childbirth develop an anal fissure. Other causes of the anal fissure are: digital insertion (during examination), foreign body insertion, or anal intercourse.
In some cases, the anal fissure may be caused by other health conditions, such as: Vitamin B-6 deficiency, abdominal pain, fever, weight loss, Crohn’s disease, inflammatory bowel disease (IBD) that causes bloody diarrhea, syphilis, a suppressed immune system, tuberculosis, HIV infection, anal cancer. A low fiber diet may also contribute to the development of a fissure.
Diagnosis can be made by inspection. Closer inspection will frequently reveal a tag or sentinel pile. After gentle separation of the skin of the anal verge, the ulcer usually posterior can be seen. Frequently the fibers of the internal anal sphincter muscle can be seen at the base of this punched-out ulcer. A well-lubricated finger with lidocaine ointment and a small caliber anoscope will help delineate the extent of the lesion. A colonoscope or sigmoidoscope exam might be useful to rule out abscesses, colitis, and other causes of rectal bleeding.
A fissure should be distinguished from an ulcer caused by Crohn’s disease, leukemia, or malignant tumors, because it is not shaggy, large or indolent. Fissures are seldom multiple. A biopsy can help to determine the diagnosis.
Often treating one’s constipation or diarrhea can cure a fissure. An acute fissure is typically managed with non-operative treatments and over 90% will heal without surgery. A high fiber diet, bulking agents (fiber supplements), stool softeners, and plenty of fluids help relieve constipation, promote soft bowel movements, and aide in the healing process. Increased dietary fiber may also help to improve diarrhea. Warm baths for 10-20 minutes several times each day are soothing and promote relaxation of the anal muscles, which can also help healing. Occasionally, special medications may be recommended. A chronic fissure may require additional treatment.
After surgery, the patient's stool habits may get altered for some days. Diet has to be restricted to avoid constipation which could be aggravate anal fissures. Pain killers and antibiotics helps the patient to recover easily after surgery.
Apart from prescribed medicines and ointments, sitz bath is also a prevalent remedial measure for this medical condition. It can be considered as a healing or cleansing method. You need to sit in a tub containing warm water for two to three times a day. This prevents fissures from becoming acute that needs to be surgically treated.
Fissure surgeries are usually minor, having a recovery period of few weeks. Unfortunately, this surgical treatment cannot provide a permanent solution to this problem. Fissures may return after surgeries as well. However, avoiding constipation by having proper diet and drinking sufficient amount of water certainly prevents its recurrence.
Fissures can recur easily, and it is quite common for a healed fissure to recur after a hard bowel movement. Even after the pain and bleeding has disappeared one should continue to aim for good bowel habits and adhere to a high fiber diet or fiber supplement regimen. If the problem returns without an obvious cause, further assessment may be needed.
A fissure that fails to respond to treatment should be re-examined. Persistent hard or loose bowel movements, scarring, or spasm of the internal anal sphincter muscle all contribute to delayed healing. Other medical problems such as inflammatory bowel disease, infections, or anal growths (skin tumors) can cause fissure-like symptoms, and patients suffering from persistent anal pain should be examined to exclude these conditions.
The fissure surgery cost in Iran will be vary,it,s depends on your hospital and your surgeon, The cost of fissure surgery in Iran starts from $430.