Lateral internal sphincterotomy

Lateral internal sphincterotomy involves cutting the sphincter muscles in your bottom to release the tension to let the fissure heal.

July 22, 2022

Lateral internal sphincterotomy involves cutting the sphincter muscles in your bottom to release the tension to let the fissure heal.

Some facts about Lateral internal sphincterotomy:

  • An anal fissure is a small tear or split in the skin around the anus.
  • A sphincterotomy may be recommended if you have an anal fissure and it hasn’t healed with self-help measures and medical treatments.
  • Anal fissures are relatively common and can cause severe pain while you’re going to the toilet.
  • The pain may continue for up to a couple of hours afterwards and they can also cause bleeding.
  • Usually a fissure develops when the sphincter muscles that control when you poo, spasm and tense up which reduces the blood supply to the area, and hence stops the tear from healing properly.
  • Anal fissures can be caused by constipation also.
  • Usually, anal fissures heal within 6 to 8 weeks by using self-help measures such as eating high fibre foods, drinking more, and taking medicines to soften your poo.
  • You can ease the symptoms by taking over-the-counter painkillers and warm baths 

Preparation for Lateral internal sphincterotomy:

  • You need to stop taking medications that may thin your blood, such as ibuprofen (Advil) or aspirin a few weeks before your surgery.
  • You should stop smoking temporarily or permanently if you’re ready to quit as smoking can make it harder for your body to heal after surgery.
  • You need to wait for any existing flu, fever, or cold to break.
  • Most of your diet should be replaced with liquids and laxatives should be taken to empty your bowels.
  • You may also need to only drink water or other clear liquids, such as broth or juice in the 24 hours before your surgery.
  • Do not eat or drink anything for up to 12 before the surgery.
  • Any medications that your surgeon gives you should be taken right before surgery.

Procedure for Lateral internal sphincterotomy:

  • Lateral internal sphincterotomy is the most effective type of surgery for anal fissure as fissure heals in most of the cases.
  • The procedure can be done either by an open sphincterotomy or closed sphincterotomy.
  • A small cut will be made in your skin by your surgeon in an open sphincterotomy so that they can see the sphincter muscle.
  • Usually, the cut is left open to heal.
  • A blade will be passed under your skin by your surgeon to reach and cut the muscle in a closed sphincterotomy.
  • Incontinence is the main complication after this type of surgery.
  • You may have problems controlling your bowels when you poo or pass wind which usually get better over time.
  • However, these problems can be permanent for a small number of people.
  • An infection which causes an abscess and an anal fistula are other possible complications.
  • Usually, the abscess is treated by draining the abscess or taking antibiotics.
  • Anal fistula is a small channel that develops between the inside of your bottom and your skin which can usually be treated with a small operation.
  • You may experience some mild to moderate pain or discomfort in your rectal area following your sphincterotomy.
  • Constipation, difficulty urinating, and possibly some rectal bleeding may also be experienced by you.