After lateral internal sphincterotomy still anal fissure come back after another hard bowel. But yet colorectal surgeon preferred sphincterotomy to botox injection. Why? Though botox injection is less costly than sphincterotomy.
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Botox effect last for 6-12 month only.
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This surgery is more successful in my opinion.
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The colonic surgeon took his decision based on many factors and sphincterotomy might not be feasible in your case.
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it is because botox injections will give short term and temporary result ; eventually requiring repeated sessions on injection therapy. properly performed lateral sphinterotomy should give you the best result without reccurence.
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Sphincterotomy is the recommended method of treatment , if conservative treatment failed or fissure is chronic , yes recurrence is high until dietary habits are changed , strictly avoid alcohol, smoking, tobacco , spicy food ..sitz bath regularly and take some mild laxatives.
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