Anal Fissure Surgery

On the day of your surgery, your consultant will talk you through what will happen and answer any final questions. You’ll then be shown to your own private patient pod, where you can change into a gown and compression stockings, which help reduce the risk of blood clots forming in your legs. A nurse will check your blood pressure, test your urine, and, in some cases, you may be asked to have an enema.

When everything’s ready, you’ll be taken to the operating suite. Your anaesthetist will give you a general anaesthetic, so you’ll be asleep and comfortable throughout the procedure.

The specific steps of the surgery will depend on the type of treatment you’re having and how severe the fissure is. Botox injections are usually quick procedures, taking around 10 minutes, while a lateral sphincterotomy or an advancement flap repair can take up to 1 hour.

After your procedure, any wounds will be dressed, and you’ll move to a private recovery area, where our specialist nursing team will monitor you as the anaesthetic wears off. Once you feel well enough, you’ll be able to go home. You’ll need someone to collect you, and you should avoid driving for at least a few days or until your consultant confirms it’s safe to do so. Your team will give you personalised advice to support your recovery at home.

If any tissue has been removed during surgery, it may be sent to the laboratory for analysis to rule out any underlying concerns. Results are usually available within a week, and a follow-up appointment may be arranged before you go home so your consultant can discuss these with you.

Anal fissure surgery is generally safe, and most people recover well. However, all procedures carry some risks. Your consultant will explain these clearly before your treatment and discuss your personal risk factors. 

Risks of anal fissure surgery include: 

• incontinence – around 1 in 10 people may notice difficulty controlling wind or very soft stool after a lateral sphincterotomy

• infection – the wound may become red, swollen, or painful, and you may need antibiotics

• bleeding – a small collection of blood (haematoma) can develop and cause bruising or swelling 

There’s also a chance that the treatment may not fully resolve your symptoms. Botox injections help around half of patients, so some people may need a second injection or a different type of procedure. Lateral sphincterotomy is much more effective, with only about 2% of patients not getting the expected improvement. Advancement flaps can sometimes struggle to heal if the blood supply to the flap is reduced, although your surgeon will discuss this carefully with you beforehand.

Your consultant will give you specific instructions based on your health and the type of surgery planned. 

You may be asked to:

• fast for 6 hours before surgery 

• stop drinking 2 hours before surgery

• stop smoking before your operation, as this helps with healing

• stop certain medications, such as blood thinners

On the day of your surgery, you may be asked to have an enema to clear your lower bowel.

After your procedure, it’s normal to have some discomfort as the anaesthetic wears off, and your consultant will explain how best to manage this at home. The amount of pain you feel can vary depending on the type of treatment you’ve had. 

Botox injections usually cause very little discomfort, and most people find that simple pain relief, such as paracetamol and ibuprofen, is enough.

If you’ve had a lateral sphincterotomy or an advancement flap repair, you may need a short course of stronger painkillers, which your surgeon will supply along with clear instructions. You may also be given other medicines, such as laxatives to prevent straining, anti-inflammatory medication, and occasionally antibiotics or tablets to protect your stomach from the effects of the anti-inflammatories.

If you’ve had a lateral sphincterotomy, you’ll have a small open wound around the anus. This needs gentle care while it heals. When you go to the toilet, instead of wiping the bottom with tissue paper, use cotton wool and fresh water. If you’re experiencing discomfort, try taking your pain relief half an hour or so before you visit the toilet. You should rinse the area once a day in the shower with fresh water and then apply a clean, dry dressing.

If you’ve had an advancement flap repair, your surgeon will provide personalised instructions on how to look after the area, as aftercare can differ slightly depending on the flap used.

Recovery from surgery is gradual, and most people start to feel noticeably better within a couple of weeks. You should avoid all exercise for the first 2 weeks, including swimming, running and going to the gym, to give the wound time to heal.

Your surgeon will usually see you for a follow-up after 2 to 3 weeks and guide you in a gradual return to activity, starting with light exercise and avoiding heavy lifting or very strenuous activity for another 2 weeks.

By 4 to 6 weeks after surgery, you should be able to resume all activities safely, including vigorous exercise. Your team will explain what changes are normal during this period, what signs to look out for, and when to get in touch for advice.

Please contact our Surgery Centre for pricing information.

At Welbeck, our colorectal surgeons are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

To book an anal fissure repair, you must be referred by either your GP, a colorectal specialist following a consultation with them. Self-referrals are not accepted for this treatment.

If you would like to schedule a consultation with a colorectal specialist, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.