Hello. For about 4 months I have been struggling with this terrible ailment which is the fissure. I have already tried practically all over-the-counter remedies as well as prescription ones prescribed by a proctologist. Unfortunately, there is practically no improvement. I still feel pain not only during defecation but also "normally" during the day. Sometimes the pain is really very strong and makes it very difficult for me to do anything. I read that it can be very helpful to inject the anus with Botox. So I asked the proctologist at my first visit about this method of treatment but after the examination he said that this procedure will not bring the expected results in my case because I did not get an increased contraction of the sphincter muscles, only there is this gap and Botox is used mainly in the case of increased tension of the sphincter muscles. Therefore, I would like to ask if the botox treatment could bring me a lot of relief, i.e. the abolition of pain despite the fact that, as I mentioned, I do not have this increased sphincter muscle spasm? PS. In my case (fissure, lack of increased contraction of the sphincter muscles) would leser treatment (Sphincterotomy) be helpful? Thank you in advance for your advice and best regards. Darius.