|An anal sphincterotomy is the surgical incision or division of the sphincter muscle that controls the anal opening (anus). Generally, it is the first surgical choice for treatment of painful cracks or tears (fissures) that develop in the interior passageway of the distal anal canal where fecal matter is channeled for final elimination from the body. Fissures usually involve just the outer skin of the anus (epithelium) but also can involve the full thickness (anal mucosa). The procedure involves cutting through the outer areas of the opening to the rectum (anal sphincter) to stretch and relax tight internal muscles; this helps prevent excessive contractions (spasms). Surgery is reserved for the acute fissures that persist after unsuccessful medical treatment or for chronic or frequently recurring fissures.|
Conservative treatment methods are tried first. When these treatments do not correct the problem, usually as a last resort, an anal sphincterotomy may be performed at the same time as a fissurectomy to remove (excise) painful fissures.
Anal fissures may occur when muscles of the anal sphincter begin to spasm as a stool passes, resulting in trauma to the anal canal. No work-related activity or specific occupation is associated with fissure development. Fissures most often develop in individuals who consume a low-fiber diet and have hard stools that are difficult to pass or who have persistent constipation. Fissures also may be linked to diseases including inflammation of the lining of the rectum (proctitis), inflammatory bowel disease (Crohn's disease or ulcerative colitis), leukemia, or certain types of cancer. In rare cases, syphilis or tuberculosis also may be an underlying cause of fissures.
Source: Medical Disability Advisor