Anal sphincterotomy

Anal Sphincterotomy

Anal Fissure Treatment - Lateral Sphincterotomy

An anal sphincterotomy is a surgical procedure performed to treat anal fissures, which are small tears in the lining of the anus. This procedure involves making a small incision in the internal anal sphincter muscle to reduce spasm and pain, thereby promoting healing of the fissure.

Indications

Anal sphincterotomy is primarily indicated for chronic anal fissures that have not responded to conservative treatments such as dietary modifications, topical medications, or botulinum toxin injections. Patients typically present with symptoms of severe anal pain, especially during and after bowel movements, and may also experience rectal bleeding.

Procedure

The procedure can be performed under local, regional, or general anesthesia, depending on the patient's condition and the surgeon's preference. There are two main types of sphincterotomy:

• Lateral Internal Sphincterotomy: This is the most common technique, where a small incision is made in the internal anal sphincter muscle on one side of the anus. This helps to relieve the pressure and allows the fissure to heal.

• Posterior Internal Sphincterotomy: Less commonly performed, this involves an incision at the posterior midline of the anus.

The choice of technique depends on the surgeon's experience and the specific needs of the patient.

Recovery and Complications

Recovery from an anal sphincterotomy is generally quick, with most patients experiencing significant pain relief within a few days. Patients are usually advised to take sitz baths, maintain a high-fiber diet, and use stool softeners to prevent straining during bowel movements.

Potential complications include:

• Infection
• Bleeding
• Fecal incontinence, which is rare but can occur if too much of the sphincter muscle is cut

Related Pages

• Anal fissure
• Hemorrhoidectomy
• Colorectal surgery