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you probably wont need surgery for anal fissures unless other forms of treatment havent worked. The surgery, called a lateral internal sphincterotomy (lis), involves making a small cut in the. Historically, an anal fissure was thought to be a result of mechanical trauma caused by a hard stool tearing the anoderm as it was passed. In addition, anal fissures have been associated with increased anal tone for many years. A proposed mechanism for increased anal tone in a study by lund showed reduced nitric oxide (no) synthase. anal fissures can be incredibly uncomfortable, so it is no wonder sufferers look for ways to relieve the discomfort. For most, though, a little patience will allow the tear to heal on its own. anal fissures, or tears in the mucous membranes supporting the anus, are very common, painful problems. Most fissures are small and temporary, generally responding well to home remedies and medications. A fissure can become a chronic nuisance for some people, however, and surgery may be recommended as a permanent cure. Anal fissures are often associated with having hard, painful bowel movements. Theyre thought to develop when muscles around your anus, called sphincter muscles, spasm and tense up. This reduces the blood supply to the area, which stops the tear from healing properly.