Anal sphincterotomy is a procedure to treat chronic anal fissures. An anal fissure is a painful tear in the lining of the anus. The anus is the opening through which stool passes from the body. Tears generally occur just inside the opening.
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Muscle spasms in the rectum can prevent fissures from healing. A sphincterotomy relieves these muscle spasms. Anal fissures often heal by taking certain steps such as:
When these do not work, a sphincterotomy may be done. This procedure allows the fissure to heal and decreases pain and spasms. Pain will begin to go away within a few days.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Before surgery, your doctor may do the following determine the extent of your fissure:
In the days leading up to the surgery, your doctor may:
You should also talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to one week before the procedure.
Depending on which option is best for you, your doctor may give you:
If there are any skin tags near the fissure, they will be removed. Next, the doctor will carefully make a cut on the anal sphincter muscle. This will relax the sphincter and allow it to stretch, taking pressure off the fissure. The doctor will put on a dressing to stop the bleeding.
Less than one hour
Anesthesetics will prevent pain during the procedure. Pain and discomfort after the procedure can be managed with medications.
You may be given pain medications and instructions for how to care for your rectal area. A nurse may change your dressing or instruct you on how to change it.
During your stay, the care center staff will take steps to reduce your chance of infection such as:
There are also steps you can take to reduce your chance of infection such as:
When you return home, you will need to take steps to promote healing and prevent infection. These will include:
Your doctor may advise:
Call your doctor if any of these occur:
If you think you have an emergency, call for emergency medical services right away.
American Society of Colon and Rectal Surgeons
Family Doctor—American Academy of Family Physicians
Canadian Society of Colon and Rectal Surgeons
The College of Family Physicians of Canada
Anal fissure expanded information. American Society of Colon and Rectal Surgeons website. Available at: https://www.fascrs.org/patients/disease-condition/anal-fissure-expanded-information. Accessed April 3, 2018.
Anal fissure. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113851/Anal-fissure. Updated May 31, 2017. Accessed April 3, 2018.
Anal fissure treatments. University of Wisconsin School of Medicine and Public Health, UW Health website. Available at: https://www.uwhealth.org/healthfacts/surgery/5467.html. Updated November 16, 2016. Accessed April 3, 2018.
Anal fissures. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/13177-anal-fissures. Updated April 24, 2014. Accessed April 3, 2018.
Anal fissures. UCSF Medical Center website. Available at: https://www.ucsfhealth.org/education/anal_fissures. Accessed April 3, 2018.
6/2/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed April 2018 by EBSCO Medical Review Board Daus Mahnke, MD Last Updated: 5/8/2014