What you need to know about:

Sphincterotomy

Fast Fact

95%

Worth It Rating

Average Cost:

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Recovery Period:

Same day discharge

Permanence:

Not specified

177

Doctors

Time it takes:

30 minutes

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Anesthetize:

Local or Regional (spinal) anesthesia

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Overview of

Sphincterotomy

in Thailand

Sphincterotomy is surgery to treat anal fissures—breaks or tears in the skin of the anal canal—caused by passing large or hard stools and/or straining during bowel movements. The contractions of the sphincter and regular bowel movements can prevent the wound from properly healing. Mild cases can be treated with topical medication and stool softeners, but more serious cases or recurrent cases may require surgery to treat. In a sphincterotomy, the outermost sphincter of the anus is removed, weakening the muscle and easing the contractions that prevent the fissure from healing. This procedure can be done in the hospital and in a clinic. It is an effective procedure and recovery takes just a few days.

Goals of

Sphincterotomy

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.

Price of

Sphincterotomy

Average Cost

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Pros and cons of

Sphincterotomy

Pros

When the sphincter muscles are contracted, they prevent anal fissures from healing. Sphincterotomy reduces tension and facilitates healing. An anal fissure is first treated with more conservative methods, including eating high-fiber food, drinking plenty of water, taking stool softeners, soaking in warm water, and applying topical medication. If these don’t work, surgery may be necessary. Surgery allows the wound to come together and heal and alleviates pain from the contraction of the sphincter muscles. It is an effective treatment that allows for fast healing for fissures.

Cons

N/A

How it works:

Sphincterotomy

In a sphincterotomy, a small incision is made in the internal anal sphincter, one of the two muscles that control the anus. This temporarily reduces the resting pressure of the anal sphincter, allowing the fissure to heal. The doctor will remove the injured tissue. Surgery may be done with local or regional (spinal) anesthesia. In some cases, general anesthesia may need to be used. The decision regarding anesthesia will depend on the patient’s preference and health, the doctor’s comfort, and the regulations of the hospital. You will be positioned on the operating bed so the doctor has comfortable access to your anus. You may either lie on your stomach with your hip slightly elevated or on your back with your legs in stirrups. The area to be operated on will be thoroughly disinfected before the procedure. The procedure takes approximately 20-30 minutes and the sutures placed are usually dissolvable. Most patients can go home after the procedure.

Preparation before

Sphincterotomy

Pre - treatment

Before the procedure, you will undergo testing that includes blood and urine tests, chest x-ray, and electrocardiogram (EKG). You may also need additional testing depending on your health and what kind of anesthesia is used for the procedure. Pre-operative testing is usually done 2-3 days before the surgery. If you take any blood thinners, including aspirin, you will need to stop these before the procedure. Please let your doctor know about all medications that you are taking and please bring all medication to the hospital on the day of the procedure. If general anesthesia is used, you will need to fast, including gum and candy, from midnight on the day of the procedure. This is to reduce the risk of aspiration while under general anesthesia, though the risk is very low.

Recovery after

Sphincterotomy

Post - treatment

While you may experience some pain after the surgery, this can be managed with prescribed medication and should not last more than a few days. You will likely have some pain with bowel movements at first, but it should be less than what you felt before the surgery. You may also notice some blood on your toilet paper after a bowel movement for the first few weeks after surgery. This is normal. Be sure to eat high-fiber foods and drink plenty of water as well as take laxatives or stool softeners for more comfortable healing after surgery. Sitting in a warm bath after bowel movements can also help. You should be able to return to your normal routine 1-2 weeks after surgery, but it can take up to 6 weeks for your anus to heal completely.

Risks & side effects

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. Typical side effects also include: Excessive bleeding Inability to control stool Urinary retention (inability to urinate) Infection Reaction to anesthesia Abscess or anal fistula

FAQs:

Sphincterotomy

What are the recommendations for travel for this procedure?

If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure. Travelers to Thailand should plan to stay in the country for at least two to five days after the procedure, depending on their condition after surgery, or for the entire duration of treatment. If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel. During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).

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What Are Anal Fissures?

Trauma to the tissue lining of the anal canal can lead to a tear or a break, which is called a fissure. Anal fissures can cause symptoms of pain, bleeding, itching, and pain during bowel movements. Fissures that are superficial and may heal fairly quickly without any treatment are considered to be acute. Those that are deeper and are still not healed after treatment or after several weeks may be considered chronic. Fissures are most often caused by passing a hard stool. Having certain medical conditions, such as hypothyroidism, obesity, and chronic constipation are also associated with an increased risk of developing an anal fissure.

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What are the symptoms of an anal fissure?

An anal fissure may cause one or more of the following symptoms: -a visible tear in the skin around your anus -a skin tag, or small lump of skin, next to the tear -sharp pain in the anal area during bowel movements -streaks of blood on stools or on toilet paper after wiping -burning or itching in the anal area

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