Sphincterotomy with or without fissurectomy
A general surgery procedure for the treatment of chronic anal fissures, indicated when conservative treatments are not enough. It provides lasting relief and supports proper healing.
What a chronic anal fissure is
These are painful tears in the anal canal that can cause significant discomfort and bleeding.
When they persist despite conservative treatment — creams, dietary changes and adjustments to bowel habits — surgery is often needed for them to heal.
Delaying treatment can prolong the pain and increase the risk of complications, such as infection or abscesses forming.
Signs you may have an anal fissure
- ✓Intense pain during or after bowel movements
- ✓Bright red blood in the stool or on the toilet paper
- ✓A burning sensation or spasm in the anal area
- ✓A visible fissure or small tear in the area
- ✓Persistent discomfort that does not improve with topical treatments
- ✓Recurring symptoms despite changes to diet or bowel habits
There is no need to wait for the pain to become unbearable before seeking an assessment.
If you recognise one or more of these signs, especially if they persist, a general surgery consultation can clarify the cause and the most suitable treatment.
How the sphincterotomy is performed
Under local or general anaesthetic, the surgeon makes a small incision in the anal sphincter, reducing muscle tension and improving blood flow to the area — which allows the fissure to heal.
Where needed, the fissure itself can also be removed (fissurectomy).
As a minimally invasive procedure, it has a high success rate, with a quick recovery and reduced discomfort.
A fissurectomy is indicated when the fissure has scar tissue or irregular edges that make healing difficult through reduced muscle tension alone.
Benefits of surgical treatment
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Pain relief — quickly resolves the discomfort associated with fissures.
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Better healing — supports recovery by improving blood flow to the area.
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A minimally invasive approach — faster recovery, with minimal disruption.
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Long-term results — lowers the risk of recurrence or further complications.
What is assessed before the procedure
Severity of the fissure
Assessment of the depth of the lesion and how long it has been present.
Muscle tension
Determining the level of sphincter tension contributing to the fissure.
Healing potential
Assessment of how well the area is likely to recover after the procedure.
Treatment follow-up
Monitoring to ensure complete resolution and the patient's comfort.
Common questions about this procedure
Is a sphincterotomy painful?+
It is performed under local or general anaesthetic, so there is no pain during the procedure. Some discomfort afterwards is normal, generally far less than the pain caused by the chronic fissure.
How long does recovery take?+
As a minimally invasive procedure, recovery is generally quick, with significant improvement in symptoms within a few days and a gradual return to usual activities.
Can a sphincterotomy affect bowel control?+
The procedure is carefully calibrated to reduce sphincter tension without compromising continence, and striking that balance is an essential part of the surgical assessment.
When is a fissurectomy needed as well as a sphincterotomy?+
A fissurectomy is indicated when the fissure has scar tissue or irregular edges that make healing difficult through reduced muscle tension alone.
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Precise surgery for anal fissures and related conditions, with specialist assessment and follow-up through to full recovery.
