Anal Fissures and the Role of Laser Surgery

Anal fissures are a common but often overlooked health issue that can cause significant discomfort and disrupt daily life. Characterized by a small tear or cut in the lining of the anus, anal fissures can lead to sharp pain during bowel movements, bleeding, and a lingering burning sensation. Although many fissures heal on their own, chronic or non-healing fissures often require medical intervention.

In recent years, laser surgery has emerged as a modern, minimally invasive solution for treating persistent anal fissures. This advanced technique offers quicker healing, less pain, and minimal downtime compared to traditional surgical approaches.

Dr. Prashanth, a leading GI and laser proctologist in Hyderabad, specializes in treating chronic anal fissures using laser technology. In this blog, we’ll explore what anal fissures are, why they occur, and how laser surgery can help patients experience long-lasting relief and a faster return to normal life.

What Is an Anal Fissure?

An anal fissure is a small tear in the thin, moist tissue (mucosa) that lines the anus. These fissures can occur as a result of:

Passing large or hard stools
Chronic constipation or diarrhea
Straining during bowel movements
Anal trauma (such as during childbirth)
Inflammatory conditions like Crohn’s disease

Fissures may be acute (recent, healing within a few weeks) or chronic (lasting longer than 6–8 weeks, often with visible scar tissue or a skin tag).

Symptoms of Anal Fissures

The hallmark symptoms of an anal fissure include:

Sharp pain during or after bowel movements
Visible tearing or cracking near the anal opening
Bleeding (bright red blood on toilet paper or in stool)
Burning, itching, or irritation around the anus
A small lump or skin tag near the fissure

While symptoms often resemble other conditions like hemorrhoids, fissures are typically more painful and may cause fear or anxiety about passing stool, worsening constipation in a vicious cycle.

Why Do Some Fissures Become Chronic?

In most cases, acute fissures heal within a few weeks with simple measures such as stool softeners, dietary changes, and topical ointments. However, some fissures persist and become chronic due to:

Persistent constipation or hard stools
Excess tension in the internal anal sphincter muscle
Poor blood flow to the affected area
Delayed or improper initial treatment

Chronic fissures can develop fibrotic edges, a sentinel pile (skin tag), or even a hypertrophied anal papilla—making healing more difficult without surgical help.

Traditional Treatments vs. Laser Surgery

For chronic anal fissures, traditional surgical treatments include:

Lateral Internal Sphincterotomy (LIS) – cutting a portion of the internal anal sphincter to reduce tension and promote healing
Fissurectomy – removing the scarred tissue to allow healthy tissue growth

While effective, these procedures can involve risks such as:

Incontinence (leakage of gas or stool)
Infection
Delayed wound healing
Postoperative pain

Enter laser surgery—a modern, minimally invasive technique that offers all the benefits of traditional treatment without many of the drawbacks.

What Is Laser Surgery for Anal Fissures?

Laser surgery for anal fissures uses a focused beam of light (laser energy) to:

Remove fibrotic or damaged tissue around the fissure
Reduce internal sphincter pressure by ablation (in selected cases)
Stimulate tissue regeneration and improve blood flow
Seal blood vessels to minimize bleeding

This approach can be combined with other minimally invasive techniques for optimal outcomes.

Benefits of Laser Surgery for Anal Fissures

Dr. Prashanth recommends laser surgery for chronic fissures due to its many advantages:

1. Minimally Invasive : Laser treatment involves no large incisions. The laser precisely targets affected tissue, preserving surrounding healthy tissue and avoiding muscle damage.

2. Less Pain : Because the laser seals nerve endings during treatment, patients report significantly less pain post-procedure compared to conventional surgery.

3. Quicker Recovery : Most patients resume normal activities within a few days. There’s no need for prolonged hospital stays or lengthy downtime.

4. Lower Risk of Incontinence : Unlike traditional sphincterotomy, laser treatment avoids cutting the sphincter muscle in most cases, reducing the risk of incontinence.

5. Minimal Bleeding : Laser cauterizes blood vessels as it works, leading to a bloodless surgical field and less post-op bleeding.

6. Outpatient Procedure : Laser fissure surgery is typically done as a daycare procedure, meaning you go home the same day—often within a few hours.

When Should You Consider Laser Surgery?

Laser treatment is an excellent option if:

Your fissure has persisted for more than 6–8 weeks
You’ve tried medications and sitz baths without relief
You experience severe pain, especially during bowel movements
There’s associated scar tissue, sentinel pile, or recurrent bleeding
You want a faster recovery with less risk than traditional surgery

Don’t ignore chronic fissure symptoms—early intervention can prevent complications and restore your quality of life.

What to Expect Before, During, and After the Procedure

Before Surgery

Dr. Prashanth will evaluate the fissure through a clinical exam or anoscopy.
You may be advised to avoid food or drink for 6–8 hours before surgery.
Routine blood tests and health screening are done.

During Surgery

Local or general anesthesia is administered.
The laser is used to remove damaged tissue and promote healing.
If needed, internal sphincter pressure is reduced using a controlled laser technique.
The procedure takes about 20–30 minutes.

After Surgery

You’ll be monitored briefly and discharged the same day.
Mild soreness or discomfort is expected but manageable with painkillers.
You’ll be advised on post-operative care, stool softeners, and hygiene.
Most patients return to work within 2–3 days.

Are There Any Risks?

Laser surgery is generally very safe when performed by a trained proctologist. Possible but rare complications include:

Mild bleeding or infection
Temporary irritation or burning sensation
Incomplete healing (in rare cases)
Recurrence (less likely with laser vs. conventional surgery)

Dr. Prashanth uses the latest laser equipment and techniques to minimize these risks and ensure excellent patient outcomes.

Why Choose Dr. Prashanth for Laser Fissure Surgery in Hyderabad?

With over 20 years of experience in proctology and minimally invasive GI surgery, Dr. Prashanth is among Hyderabad’s most trusted laser surgeons. His clinic offers:

Advanced laser equipment with precision targeting
High success rates in treating chronic anal fissures
Daycare procedures with same-day discharge
Personalized care in a calm, patient-friendly setting
Transparent consultations with clear post-op guidance

Whether you’ve been silently suffering or have had poor results with prior treatments, Dr. Prashanth provides the care and expertise you need.

Don’t Let Anal Fissures Control Your Life

Living with the pain and anxiety of chronic anal fissures can take a serious toll on your well-being. But with modern laser surgery, relief is quicker, safer, and more effective than ever before.

If you’ve tried conservative treatments without success, it may be time to explore a long-term solution. Book a consultation with Dr. Prashanth today and take the first step toward healing, comfort, and peace of mind.