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These notes give an overall guide to your stay in hospital. You may see some differences in the details of your treatment, since it is tailored to suit your own condition.
WHAT IS AN ANAL FISSURE
An anal fissure is a small tear running from the skin near the back passage and opening into the anal canal higher up. This is a painful condition usually associated with fresh bleeding after bowel actions.
What does the operation consist of?
The fissure is aggravated by spasm of the circular anal muscle. This is stretched slightly and then partially divided. This results in relief of the spasm and thus the pain, allowing the fissure to heal.
WHAT HAPPENS BEFORE THE OPERATION
Reception
When registering at reception your medical aid details will be required. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission.
Welcome to the ward
You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses.
Visit by the anaesthetist
If you are having a general anaesthetic, the anaesthetist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had.
Diet
You will have your usual diet until 6 hours before the operation when you will be asked to take nothing by mouth. This will let your stomach empty to prevent vomiting during the operation.
Shaving
The operation area will be shaved to remove excess hair.
Timing of the operation
The timing of your operation is usually arranged the day before so that the nurses will tell you when to expect to go to the operating theatre. Do not be surprised, however, if there are changes to the exact timing.
Transfer to theatre
You will be taken on a trolley to the operating suite by the staff. You will be wearing a cotton gown, wedding rings will be fastened with tape and removable dentures will be left on the ward. There will be several checks on your details on the way to the operating theatre where your anaesthetic will begin.
The operation is then performed.
WHAT HAPPENS AFTER THE OPERATION
Coming round after the anaesthetic
Although you will be conscious a minute or two after the operation ends you are unlikely to remember anything until you are back in your bed on the ward. Some patients feel a bit sick for up to 24 hours after operation, but this passes off. You will be given some treatment for sickness if necessary.
Will it hurt?
There is discomfort rather than pain, in fact after the operation you will usually be better particularly when having a bowel motion. You will be given injections or tablets to control this as required. Ask for more if the pain is still unpleasant.
Opening bowels
The first time you open your bowels it may be a bit painful but this rapidly improves. If you have not opened your bowels after two days and you feel uncomfortable, contact the doctor. It is important not to become constipated. You will be given medication to assist this. Drink plenty of liquids and eat enough roughage.
Passing urine
It is important that you pass urine and empty your bladder within 6-12 hours of the operation.
The wound
The wound has a pad only, sometimes held on with elastic netting pants. There may be some staining with old blood during the first 12 hours. The pad can be removed after operation. You can bath and shower as you wish.
Washing
You can wash the anal area as normal.
How long in hospital?
You can usually go home after the operation. Occasionally staying overnight is advisable, when the fissure is very painful or the procedure has been done late in the day.
Sick notes
Please ask your surgeon for any sick notes or certificates that you may require.
Driving
You can drive after 24 hours.
What about sex?
You can restart sexual activities as soon as you are comfortable.
Work
You should be able to return to work within 2 days.
Complications
Complications are seldom serious. Opening your bowels becomes rapidly easier particularly if you take a laxative. Occasionally you may notice difficulty controlling the wind through your back passage. This improves after a day or two. It is very rare for this to be an ongoing problem, however it is a rare complication of the procedure but usually in the older patient.
The chance of the fissure coming back again is small.
Please call our rooms if:
- you have not had a bowel action for 2 days
- your temperature is higher than 380C
- you are concerned
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