When does a fracture need to be operated on?
In most cases, a fresh crack heals conservatively - against the background of normalization of stool, baths and medications that relieve sphincter spasm. If the crack exists for more than 2 months, its edges thicken and scar, a sentinel tubercle appears, and the sphincter spasm becomes persistent - healing without surgery is no longer possible. The surgeon excises a crack within healthy tissue along with scars; in case of severe spasm, the intervention is supplemented with dosed lateral sphincterotomy, which breaks the vicious circle of “spasm - ischemia - pain”.
Outpatient proctology
A significant part of proctological problems can be solved by minor interventions that do not require long-term hospitalization: excision of a fissure, removal of a polyp of the anal canal, bougienage for narrowing, cauterization of fimbriae.
What they all have in common is a short turnaround time, local or spinal anesthesia, and a recovery time of 1-3 weeks. Many include one bed day for observation and pain management in the first hours.
Anal fissure
A fissure is a linear defect in the mucous membrane of the anal canal, causing severe pain during defecation and sphincter spasm. Spasm impairs blood supply and interferes with healing - a vicious circle is formed. A fresh crack is treated conservatively, and a chronic one, with scarred edges and a guard tubercle, is excised surgically.
Diagnostics
Sigmoidoscopy allows you to examine the rectum and part of the sigmoid colon to a depth of 25–30 cm. This is a basic endoscopic examination in proctology: it identifies polyps, inflammatory changes, sources of bleeding and tumors of the lower sections.