When LIS is considered
LIS may be advised when chronic fissure persists despite correct medical care or Botox in suitable patients.
Persistent pain
Spasm-driven non-healing
Failed conservative care
Fissure Treatment
Lateral Sphincterotomy
Lateral internal sphincterotomy, or LIS, treats selected chronic fissures by reducing internal sphincter pressure. It can be highly effective but requires careful risk discussion.
Treatment Pathway
1
When LIS is considered
Persistent pain
2
Why assessment is careful
Baseline control
3
After LIS
Avoid constipation
Key Treatment Points
Lateral internal sphincterotomy, or LIS, treats selected chronic fissures by reducing internal sphincter pressure. It can be highly effective but requires careful risk discussion.
Why assessment is careful
The surgeon evaluates continence history, childbirth injury, prior surgery and other risk factors before advising LIS.
Baseline control
Previous anorectal surgery
Patient-specific risk
After LIS
Recovery still requires stool-softening, hygiene and follow-up to protect healing.
Avoid constipation
Report leakage or severe pain
Attend review
Related Reading
Explore Related Topics
Continue learning about anal fissure — each linked topic adds important clinical context to help you prepare for your consultation.
FAQ
Frequently Asked Questions
Is LIS always needed for chronic fissure?
No. Some patients may improve with medicines or Botox, while others need surgery.
What is the main risk?
Continence change is the key risk to discuss, even though many patients do well.
Can fissure recur after LIS?
Recurrence is less common but possible, especially if constipation continues.
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Care Notes
For selected chronic fissure
Reduces sphincter pressure
Continence risk must be discussed
Medical references used for this guide
This page is educational and does not replace a clinician's examination. References reviewed include ASCRS anal fissure expanded information, Mayo Clinic anal fissure symptoms and causes, and Cleveland Clinic anal fissure guide.