Recovery time after anal fissure surgery

• Anal fissure can be resolved surgically with a definitive success rate of close to 100% of cases.
• The care and recommendations at home after anal fissure surgery are simple and aimed at a speedy recovery.
• After anal fissure surgery, the discomfort, so intense for most patients, will disappear definitively in a matter of days.

An anal fissure is a wound; a dilaceration; a small tear in the anal area, specifically on the mucosa of the anal sphincter, which has not healed within a reasonable time of 6 to 8 weeks and which can appear in cases of chronic constipation, persistent diarrhoea or even in the case of anal intercourse without the advisable lubrication measures.

Anal fissure is a very uncomfortable condition that becomes apparent after defecation (whether there is constipation or diarrhoeal faeces). The discomfort is sometimes so intense that the individual avoids the act of defecation in order to avoid the episode that follows. It is a sensation in which a mixture of intense pain, itching, stinging and burning may be experienced; it may last even for a few hours after defecation.

A high percentage of anal fissures can heal with conservative procedures on their own. Others, however, require a surgical procedure, these being chronic anal fissures.

In chronic anal fissures (those that last more than 8 weeks or heal but recur over time), if conventional and conservative treatments have failed, anal fissure surgery or sphincterotomy is the definitive solution.

It is a simple and uncomplicated surgical procedure that requires a short operation time of no more than 45 minutes under regional anaesthesia.

Anal fissure surgery involves performing a sphincterotomy. Sphincterotomy consists of the surgeon making incisions of approximately one centimetre inside the tissue that covers the sphincter and in this way the internal lateral sphincter is sectioned. This surgical treatment has excellent results. Patients who undergo sphincterotomy usually have no further problems with anal fissures.

In addition, discomfort after the procedure is usually minimal and very well tolerated.

The hospital stay after anal fissure surgery is usually one day. In some cases it is even done on an outpatient basis and you can leave the hospital after the operation and go home.

The most common situation is to go home the day after the operation, with specific instructions on the post-surgical care to be carried out at home.

Beforehand, the doctor will check the surgical wound and together with the nursing staff will perform the first dressing, giving sufficient training on how you will have to continue with the care of the surgical wound at home.

Complete recovery after discharge from hospital after anal fissure surgery takes about three weeks. It basically depends on the healing time of the surgical wound. You should be rigorous with the post-operative care that your surgeon will give you.

These recommendations may include everything from sitz baths 2-3 times a day to a diet rich in fibre to ensure a soft stool consistency and avoid constipation.

Sometimes laxatives will be used to control the bowel rhythm, and it may even be necessary to take painkillers prescribed by the surgeon.

It is not advisable to use ointments, creams, creams or dressings on the operated area.

To summarise the care at home after anal fissure surgery, we can say:

• Wait one day after the operation before showering. Do not use abrasive soaps and do not rub the operated area. The best soap to use is PH Neutral.
• Eat a balanced diet, rich in fibre to prevent constipation. Use laxatives under medical supervision if necessary.
• At bowel movement time, do not spend too much time sitting on the toilet, as this can stress the surgical wound and cause bleeding.
• Do not use ointments, creams or ointments on the surgical wound.
• Avoid straining, do not lift heavy objects, you could suffer small tears and dilacerations and delay healing.
• Do not take any painkillers without your doctor's authorisation, especially narcotic painkillers which can aggravate constipation.
• Sitz baths are recommended, both for hygiene and because they are very useful for relieving discomfort.
• Donut-shaped cushions are recommended to avoid pressure on the operated area.
• If the surgical wound bleeds a little in the first few days, this is normal and should not be considered important.

In 90% of cases, within 15 days of the operation, the discomfort and/or pain in the anal area disappears.

Return to work can be around 2-3 weeks after the operation in most cases.

However, each case is subject to the specific progress observed by your doctor. He or she will advise you on your return to work.

Let us give some examples of jobs, to make it easier to identify your case:

A person who spends his working day sitting down

Secretary, office clerk, IT specialist, banker, dressmaker, taxi driver, bus driver or transport driver in general, etc. These patients, if they have undergone anal fissure surgery and have to return to their normal work after the convalescence period, can return to work earlier. However, they should follow the following advice:

1. Remember to get up from your work chair and take a short walk every hour.
2. Use a round cushion to relieve pressure on the surgical scar area.
3. Use a foot lifter to promote return circulation.

People who spend their day on the move

People who spend their day moving from one place to another or who spend a lot of time on their feet (teacher, salesperson, shop assistant, caretaker, porter, salesperson.....), should consider reducing this time, especially during the first few days after starting work. Take breaks by sitting down and stretching your legs on a stool to facilitate venous return.

People who do a lot of physical work during a working day

Construction workers, butane and water delivery workers, removal workers, etc. These people should consult their specialist doctor when they should return to work, as the intensity of the physical exercise they do could pose a risk to the healing of the surgical wound if they return to work before the optimum and recommended time.

Complications of anal fissure surgery are few and minor, such as infection of the surgical wound, faecal incontinence (in less than 1 % and in severe cases), infectious abscesses and others.

The most relevant complication is recurrence of the anal fissure that would require reassessment for possible surgical intervention. This occurs rarely, in very severe cases and with very inexperienced or unskilled doctors.

In the vast majority of cases, if recovery is carried out correctly and without overexertion, there should be no recurrence or complication of the anal fissure.

Vaginal intercourse can be resumed relatively soon, as the perianal area near the vagina is not affected. It will therefore depend on the healing of the anal region and the residual peri-scar oedema, which is the swelling around the surgical wound that disappears on its own as the days go by.

You can be fully recovered in 15-21 days, depending on the case.

As for anal sex, you will have to wait longer. Until, in addition to the sphincter having healed, the skin covering it is sufficiently elastic so that it does not break during intercourse.

It is very, very important to lubricate the area well before penetration. The first time after surgery you should be very careful and not be in a hurry.

If, despite this, intercourse is uncomfortable or painful, wait a few more days to try again.

Remember that at Operarme, we offer you a free surgical assessment consultation so that you can meet our surgeon and schedule the operation as soon as possible. 

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