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What is a Sphincterotomy?
Sphincterotomy is a procedure in which anal fissures are treated. A tear in the rectal lining which most often results from hard bowel movement is called an anal fissure. Due to muscle spasms and continuous bowel movements, the healing of the anal fissures is prevented. They become very severe and cause great pain and discomfort. Medication to encourage healing and stool softeners can also be used to heal the anal fissures. However, severe and reoccurring fissures need to be treated by sphincterotomy. The outermost portion of the anal sphincter is cut during a sphincterotomy, which loosens the muscles and stops the muscle spasms from occurring.
How is a sphincterotomy performed?
The patient needs to lie down on the operating table and is positioned in a way to expose the anus and the rectal area. Once the anesthesia is given, an antiseptic solution is used to clean the area. Then, fissures are removed and an incision is made on the anal sphincter. This enables the sphincter to relax and stretch. This causes less strain on the fissure. Stitches are given and the patient is sent into recovery.
How to prepare for a sphincterotomy?
- A few days prior to the sphincterotomy, the doctor may be required to do some tests on you which include:
- Urine tests
- Chest x-ray
- Other tests depending on the patient’s health
- You may be required to stop certain medication for several days before the procedure if it is advised by your doctor.
- You will have an interview with an anesthesiologist to determine which anesthesia you need to be provided.
- The doctor may impose dietary restrictions before the procedure.
Duration of procedure/surgery : 20 to 30 minutes
Days admitted : None. Sphincterotomy is done on an outpatient basis.
Anesthesia : Local anesthesia is usually administered for a sphincterotomy. However, an interview with the anesthesiologist before the sphincterotomy will determine if you need general or any other anesthesia.
Recovery : - After the procedure, the patient is monitored in a recovery unit. Clear fluids are given until the patient recovers from anesthesia.
- Depending on the complexity of the procedure, the duration of the patient’s stay in the hospital is determined. Most often patients are sent home without much delay.
- Approximately 2 weeks is required for a patient to recover from a sphincterotomy, and resume normal activities.
- A complete recovery may take approximately 2 months.
Risks : The possible complications during a sphincterotomy include the following:
- Infection of the surgical area
- Severe discomfort
- Abnormal discharges
- Uncontrolled flatulence
After care : - You will experience soreness and bleeding around the anus. A bland diet that is high in fiber and fluids may be recommended by the doctor to avoid soreness around the surgical area.
- The dressing on the operated site should be kept for many hours after your discharge.
- You may take sitz baths twice a day to keep the operated region clean, and to lessen the pain.
- Pain gradually lessens within a few days.
- You should maintain scrupulous hygiene during your recovery period to avoid infection.
- Inform the doctor if you experience bleeding, fever, soreness around the incision, and drainage from the incision
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