A lateral internal sphincterotomy is a simple surgery during which the sphincter is cut or stretched. The sphincter is the circular group of muscles surrounding the anus that are responsible for controlling bowel movements.
This type of sphincterotomy is a treatment for people who suffer from anal fissures. Anal fissures are breaks or tears in the skin of the anal canal. A sphincterotomy is used as a last resort for this condition, and people who experience anal fissures are usually encouraged to try a high-fiber diet, stool softeners, or Botox first. If symptoms are severe or don’t respond to these treatments, a sphincterotomy may be offered.
There are several other procedures that are often performed alongside a sphincterotomy. These include a hemorrhoidectomy, a fissurectomy, and a fistulotomy. You should check with your doctor to see precisely which procedures will be performed and why.
During the procedure, the surgeon makes a small incision in the internal anal sphincter. The aim of this incision is to release the tension of the sphincter. When the pressure is too high, anal fissures are unable to heal.
A sphincterotomy can be performed under local or general anaesthetic, and you will normally be allowed to return home on the same day as the surgery takes place.
It will normally take about six weeks for your anus to fully heal, but most people are able to resume their normal activities including going to work within one to two weeks after the surgery.
Most people find that the pain they were experiencing from their anal fissure prior to surgery has disappeared within a few days of having their sphincterotomy. Many people worry about having their bowels move after the surgery, and while it’s normal to experience some pain during bowel movements at first, the pain is usually less than it was before the surgery. It’s also normal to notice some blood on the toilet paper after a bowel movement for the first few weeks.
There are many things you can do to help aid in your recovery:
- Get plenty of rest.
- Try to walk a little each day.
- Follow your doctor’s instructions as to when you can drive again.
- Shower or bathe as normal, but pat your anal area dry afterward.
- Drink plenty of fluids.
- Eat a high-fiber diet.
- If you are struggling with constipation, ask your doctor about taking a mild laxative or stool softener.
- Take your pain medications exactly as described.
- Sit in around 10 centimeters of warm water (sitz bath) three times daily and following bowel movements until the pain in your anal area subsides.
- When attempting to move your bowels, use a small step to support your feet. This will flex your hips and place your pelvis in a squatting position, which can help you to pass a stool more easily.
- Using baby wipes instead of toilet paper is often more comfortable and doesn’t irritate the anus.
- Avoid using fragranced soaps.
Side effects and potential risks of a sphincterotomy
A lateral internal sphincterotomy is a simple and widely performed procedure and is highly effective in the treatment of anal fissures. It’s not usual for there to be any side effects following the surgery, but they do occur in an extremely rare occasion.
It’s very normal for people to experience minor fecal incontinence and difficulty controlling flatulence in the immediate weeks after the surgery. This side effect usually resolves on its own as your anus heals, but there are some cases where it has been persistent.
It’s possible for you to hemorrhage during the operation and this would usually require stitches.
It’s also possible for you to develop a perianal abscess, but this is usually associated with an anal fistula.
A lateral internal sphincterotomy is a simple procedure that has proven to be highly successful in the treatment of anal fissures. You will be encouraged to try other treatment methods before surgery, but if these are ineffective, you will be offered this procedure. You should recovery relatively quickly from a sphincterotomy and there are many comfort measure you can use while you are healing. Side effects are extremely rare and can be treated if they do occur.